Indications for and diagnostic yield of capsule endoscopy in the elderly

• Published in: Revista de Gastroenterología de México (English Edition) Vol. 83; no. 3; pp. 238 - 244
• Main Authors: Pérez-Cuadrado-Robles, E, Zamora-Nava, L E, Jiménez-García, V A, Pérez-Cuadrado-Martínez, E
• Format: Journal Article
• Language: English; Spanish
• Published: Mexico 01.07.2018
• Subjects: Adult; Aged; Aged, 80 and over; Aging; Capsule Endoscopy - statistics & numerical data; Female; Gastrointestinal Diseases - diagnosis; Gastrointestinal Diseases - diagnostic imaging; Gastrointestinal Hemorrhage - diagnosis; Gastrointestinal Hemorrhage - diagnostic imaging; Gastrointestinal Transit; Humans; Male; Middle Aged; Prospective Studies; Pacientes mayores; Capsule endoscopy; Small bowel; Obscure gastrointestinal bleeding; Older patients; Ancianos; Elderly; Sangrado gastrointestinal de origen oscuro; Intestino delgado; Endoscopia por cápsula
• ISSN: 0375-0906; 2255-534X
• DOI: 10.1016/j.rgmx.2017.08.004

The growing elderly population and wide use of capsule endoscopy have led to a higher number of procedures in those patients. The aim of the present study was to assess the usefulness of capsule endoscopy in older patients. All consecutive patients undergoing capsule endoscopy at our center within the time frame of 2004-2016 were classified as older (≥75 years of age) and younger. Findings and diagnostic yield were comparatively assessed. Of 2311 patients (mean age: 59.5 ± 19.23 years, 44.48% male), 648 were in the older group and 1663 in the younger group. Gastric transit time was shorter in the older patients (p=0.001), whereas small bowel transit time was shorter in the younger patients (p<0.001). Overall diagnostic yield in the elderly was higher (50.66% vs. 41.19%, p<0.001). Obscure gastrointestinal bleeding was the most frequent indication for capsule endoscopy in the elderly (90.4% vs. 53.77%, p<0.001), achieving a higher diagnostic yield than in the younger population (51.47% vs. 42.76%, p=0.002), whereas Crohn's disease, suspected or known neoplasms/polyps, malabsorption syndrome, and abdominal pain were the indications in the younger patient group. Such indications were rare in the older group. Vascular lesions and active bleeding were more frequently diagnosed in the older patients, whereas ulcers/erosions and mucosal atrophy were more common in the younger patients (p<0.001). Capsule endoscopy achieved a higher overall diagnostic yield in the elderly patients. Obscure gastrointestinal bleeding indication for capsule endoscopy was much more frequent in the advanced-age group and had a higher diagnostic yield.