Meta-analysis shows similar re-bleeding rates among Western and Eastern populations after index video capsule endoscopy
(2018) In Digestive and Liver Disease 50(3). p.226-239- Abstract
Background & aims: Video capsule endoscopy (VCE) is the first-line diagnostic procedure for investigating obscure gastrointestinal bleeding (OGIB). Different re-bleeding rates following index VCE have been reported among Western and Eastern studies. Methods: We conducted a comprehensive literature search to identify studies examining re-bleeding rates after VCE for OGIB. Meta-analysis assessed the pooled proportion of re-bleeding events after VCE for OGIB according to study's origin (Western vs. Eastern) and according to the length of follow-up (≥24 months vs. <24 months). We also calculated the re-bleeding odds ratios (OR; 95% CI) after positive vs. negative index VCE, overt vs. occult initial presentation of bleeding and after... (More)
Background & aims: Video capsule endoscopy (VCE) is the first-line diagnostic procedure for investigating obscure gastrointestinal bleeding (OGIB). Different re-bleeding rates following index VCE have been reported among Western and Eastern studies. Methods: We conducted a comprehensive literature search to identify studies examining re-bleeding rates after VCE for OGIB. Meta-analysis assessed the pooled proportion of re-bleeding events after VCE for OGIB according to study's origin (Western vs. Eastern) and according to the length of follow-up (≥24 months vs. <24 months). We also calculated the re-bleeding odds ratios (OR; 95% CI) after positive vs. negative index VCE, overt vs. occult initial presentation of bleeding and after interventional treatment for positive index cases, according to the study's origin. Results: We included 46 (30 Western and 16 Eastern) studies with 5796 patients. Significant heterogeneity was detected among meta-analyzed studies. Overall, the pooled re-bleeding rate was similar between Western (29%; 95% CI: 23-34) and Eastern (21%; 95% CI: 15-27) populations, irrespective of the length of follow-up. The odds of re-bleeding was significantly higher after positive as compared to negative index VCE in Eastern studies (OR: 1.77; 95% CI: 1.07-2.94). Application of specific treatment after positive index VCE was associated with lower re-bleeding odds in both Western (OR: 0.37; 95% CI: 0.16-0.87) and Eastern (OR: 0.39; 95% CI: 0.21-0.72) populations. Conclusions: Patients undergoing VCE for OGIB have similar re-bleeding rates in the East and the West, regardless of the length of follow-up. However, increased re-bleeding odds after positive index VCE is observed in Eastern studies.
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- author
- Tziatzios, Georgios ; Gkolfakis, Paraskevas ; Hassan, Cesare ; Toth, Ervin LU ; Zullo, Angelo ; Koulaouzidis, Anastasios ; Dimitriadis, George D. and Triantafyllou, Konstantinos
- organization
- publishing date
- 2018-03
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- East, Obscure gastrointestinal bleeding, Re-bleeding rate, Video capsule endoscopy, West
- in
- Digestive and Liver Disease
- volume
- 50
- issue
- 3
- pages
- 226 - 239
- publisher
- Elsevier
- external identifiers
-
- scopus:85041212213
- pmid:29396130
- ISSN
- 1590-8658
- DOI
- 10.1016/j.dld.2017.12.031
- language
- English
- LU publication?
- yes
- id
- 1df6eae7-8979-439d-a92b-9801c81d1348
- date added to LUP
- 2018-02-21 14:34:54
- date last changed
- 2024-04-01 01:30:27
@article{1df6eae7-8979-439d-a92b-9801c81d1348,
abstract = {{<p>Background & aims: Video capsule endoscopy (VCE) is the first-line diagnostic procedure for investigating obscure gastrointestinal bleeding (OGIB). Different re-bleeding rates following index VCE have been reported among Western and Eastern studies. Methods: We conducted a comprehensive literature search to identify studies examining re-bleeding rates after VCE for OGIB. Meta-analysis assessed the pooled proportion of re-bleeding events after VCE for OGIB according to study's origin (Western vs. Eastern) and according to the length of follow-up (≥24 months vs. <24 months). We also calculated the re-bleeding odds ratios (OR; 95% CI) after positive vs. negative index VCE, overt vs. occult initial presentation of bleeding and after interventional treatment for positive index cases, according to the study's origin. Results: We included 46 (30 Western and 16 Eastern) studies with 5796 patients. Significant heterogeneity was detected among meta-analyzed studies. Overall, the pooled re-bleeding rate was similar between Western (29%; 95% CI: 23-34) and Eastern (21%; 95% CI: 15-27) populations, irrespective of the length of follow-up. The odds of re-bleeding was significantly higher after positive as compared to negative index VCE in Eastern studies (OR: 1.77; 95% CI: 1.07-2.94). Application of specific treatment after positive index VCE was associated with lower re-bleeding odds in both Western (OR: 0.37; 95% CI: 0.16-0.87) and Eastern (OR: 0.39; 95% CI: 0.21-0.72) populations. Conclusions: Patients undergoing VCE for OGIB have similar re-bleeding rates in the East and the West, regardless of the length of follow-up. However, increased re-bleeding odds after positive index VCE is observed in Eastern studies.</p>}},
author = {{Tziatzios, Georgios and Gkolfakis, Paraskevas and Hassan, Cesare and Toth, Ervin and Zullo, Angelo and Koulaouzidis, Anastasios and Dimitriadis, George D. and Triantafyllou, Konstantinos}},
issn = {{1590-8658}},
keywords = {{East; Obscure gastrointestinal bleeding; Re-bleeding rate; Video capsule endoscopy; West}},
language = {{eng}},
number = {{3}},
pages = {{226--239}},
publisher = {{Elsevier}},
series = {{Digestive and Liver Disease}},
title = {{Meta-analysis shows similar re-bleeding rates among Western and Eastern populations after index video capsule endoscopy}},
url = {{http://dx.doi.org/10.1016/j.dld.2017.12.031}},
doi = {{10.1016/j.dld.2017.12.031}},
volume = {{50}},
year = {{2018}},
}