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Subject(s)
Humans , Male , Aged, 80 and over , Diarrhea/chemically induced , Adrenergic alpha-Antagonists/adverse effects , Prostatic Hyperplasia/drug therapySubject(s)
Diarrhea/chemically induced , Indoles/adverse effects , Adrenergic alpha-1 Receptor Antagonists/adverse effects , Adrenergic alpha-1 Receptor Antagonists/therapeutic use , Aged, 80 and over , Diagnosis, Differential , Humans , Male , Prostatic Hyperplasia/complications , Prostatic Hyperplasia/surgery , Urination Disorders/drug therapy , Urination Disorders/etiologyABSTRACT
INTRODUCCIÓN: Nuestro objetivo fue evaluar el impacto clínico y la seguridad, así como estimar el gasto de la cápsula endoscópica (CE) en nuestro centro. RESULTADOS: Se analizaron retrospectivamente los estudios realizados en nuestro centro desde el año 2009 hasta 2012. Las indicaciones más frecuentes fueron el estudio de anemia (39%),el estudio de la hemorragia digestiva de origen incierto (HDOO) (19%) y de la enfermedad inflamatoria intestinal (EII) (18%). Se encontraron hallazgos positivos en un 51% de los casos, lo que tuvo impacto clínico en el 36,5%. La EII fue la indicación en la que la CE tuvo mayor impacto clínico (74,5%, p < 0,001). El impacto clínico de la CE en la HDOO o la anemia fue del 41 y el 26%, respectivamente. Una aproximación al gasto de las exploraciones recogidas supone una inversión de al menos 132.600 €; dado que el 63,5% de las exploraciones no tuvo impacto clínico quiere decir que la inversión de hasta 84.200 € no tuvo repercusión en el manejo de los pacientes. En aquellos pacientes que recibieron CE por un cuadro de HDOO se relacionó la realización precoz de la prueba (< 7 días) con la presencia de hallazgos patológicos y de impacto clínico. No se encontraron otros factores epidemiológicos, clínicos o analíticos capaces de predecir la presencia del impacto clínico de la CE en las diferentes indicaciones. CONCLUSIONES: En nuestra experiencia, la realización de la CE tuvo mayor impacto clínico en el estudio de la EII, y de la HDOO si se realiza de forma precoz; por el contrario, sería necesario un esfuerzo en mejorar las indicaciones de CE en el estudio de anemia para conseguir un mayor impacto clínico en este contexto
INTRODUCTION: T he aim of this study was to evaluate the safety, clinical impact and costs associated with capsule endoscopy (CE) in our center. RESULTS: We retrospectively analyzed the CE procedures carried out in our center from 2009 to 2012. The most frequent indications were investigation of anemia (39%), obscure gastrointestinal bleeding (OGIB) (19%) and inflammatory bowel disease (IBD)(18%). Findings were positive in 51% of the patients, which had a clinical impact in 36.5%. The indication in which CE had the greatest clinical impact was IBD (74.5%, p < 0,001). The clinical impact of CE in OGIB and anemia was 41% and 26%, respectively. The procedures performed represented an investment of at least 132 600€; since 63.5% of the procedures had no clinical impact, an investment of 84 200€ had no effect on patient management. In patients who underwent CE for OGIB, early performance of the procedure (< 7 days) was related to the presence of pathological findings and clinical impact. We found no other epidemiological, clinical or analytic factors able to predict the clinical impact of CE in the various indications
Subject(s)
Humans , Capsule Endoscopes , Gastrointestinal Diseases/diagnosis , Retrospective Studies , /statistics & numerical data , Gastrointestinal Hemorrhage/diagnosis , Inflammatory Bowel Diseases/diagnosis , Anemia/etiologyABSTRACT
INTRODUCTION: The aim of this study was to evaluate the safety, clinical impact and costs associated with capsule endoscopy (CE) in our center. RESULTS: We retrospectively analyzed the CE procedures carried out in our center from 2009 to 2012. The most frequent indications were investigation of anemia (39%), obscure gastrointestinal bleeding (OGIB) (19%) and inflammatory bowel disease (IBD)(18%). Findings were positive in 51% of the patients, which had a clinical impact in 36.5%. The indication in which CE had the greatest clinical impact was IBD (74.5%, p<0,001). The clinical impact of CE in OGIB and anemia was 41% and 26%, respectively. The procedures performed represented an investment of at least 132 600; since 63.5% of the procedures had no clinical impact, an investment of 84 200 had no effect on patient management. In patients who underwent CE for OGIB, early performance of the procedure (<7 days) was related to the presence of pathological findings and clinical impact. We found no other epidemiological, clinical or analytic factors able to predict the clinical impact of CE in the various indications. CONCLUSIONS: In our experience, CE had the greatest impact in the study of IBD and, if performed early, in OGIB. However, the indications for CE in the study of anemia should be most precisely defined to achieve a greater clinical impact in this disorder.