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

Georgios Tziatzios, Paraskevas Gkolfakis, Cesare Hassan, Ervin Toth, Angelo Zullo, Anastasios Koulaouzidis, George D. Dimitriadis, Konstantinos Triantafyllou

Research output: Contribution to journalReview article

4 Citations (Scopus)

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 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.

Original languageEnglish
Pages (from-to)226-239
Number of pages14
JournalDigestive and Liver Disease
Volume50
Issue number3
DOIs
Publication statusPublished - Mar 2018

Keywords

  • East
  • Obscure gastrointestinal bleeding
  • Re-bleeding rate
  • Video capsule endoscopy
  • West

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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    Tziatzios, G., Gkolfakis, P., Hassan, C., Toth, E., Zullo, A., Koulaouzidis, A., Dimitriadis, G. D., & Triantafyllou, K. (2018). Meta-analysis shows similar re-bleeding rates among Western and Eastern populations after index video capsule endoscopy. Digestive and Liver Disease, 50(3), 226-239. https://doi.org/10.1016/j.dld.2017.12.031