Abstract
Background
Small bowel capsule endoscopy (SBCE) is the recommended first-line procedure for obscure
gastrointestinal bleeding (OGIB). However, a method for predicting the necessity of
subsequent double-balloon endoscopy (DBE) has not been established.
Aims
We aimed to develop a new scoring system that predicts the necessity of DBE in OGIB.
Methods
A retrospective study was performed in 330 patients who underwent SBCE for OGIB at
Nagoya University Hospital. The enrolled patients were randomly assigned to either
a development or a validation dataset. The former was used to construct a prediction
scoring system to assess the necessity of DBE using independent predictors selected
by logistic regression. The diagnostic yield of the prediction model was assessed
using the validation dataset.
Results
Multivariate logistic regression analysis of the development dataset identified OGIB
type, blood transfusion, and SBCE findings as independent predictors of the necessity
of DBE. A prediction score gave an area under the receiver operating characteristics
curve of 0.77. The sensitivity, specificity, positive predictive value, and negative
predictive value at a cutoff ≥2.5 points were 72.5%, 74.6%, 72.6%, and 74.5%, respectively.
Conclusion
Our scoring system may aid clinicians in deciding when to recommend DBE for patients
with OGIB.
Keywords
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Article info
Publication history
Published online: September 01, 2017
Accepted:
August 23,
2017
Received in revised form:
August 22,
2017
Received:
January 10,
2017
Identification
Copyright
© 2017 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.
