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Meta-analysis shows similar re-bleeding rates among Western and Eastern populations after index video capsule endoscopy

Tziatzios, Georgios; Gkolfakis, Paraskevas; Hassan, Cesare; Toth, Ervin LU ; Zullo, Angelo; Koulaouzidis, Anastasios; Dimitriadis, George D. and Triantafyllou, Konstantinos (2018) In Digestive and Liver Disease
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
organization
publishing date
type
Contribution to journal
publication status
epub
subject
keywords
East, Obscure gastrointestinal bleeding, Re-bleeding rate, Video capsule endoscopy, West
in
Digestive and Liver Disease
publisher
Elsevier
external identifiers
  • scopus:85041212213
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
2018-07-15 04:47:37
@article{1df6eae7-8979-439d-a92b-9801c81d1348,
  abstract     = {<p>Background &amp; 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. &lt;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},
  keyword      = {East,Obscure gastrointestinal bleeding,Re-bleeding rate,Video capsule endoscopy,West},
  language     = {eng},
  month        = {01},
  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},
  year         = {2018},
}