P3004 - Inpatient Capsule Endoscopy of Patients With Iron Deficiency Anemia Is Associated With Higher Therapeutic Yield and Shorter Time From Negative Endoscopy to Evaluation

Soonwook Hong, MD¹, Saif Laljee, MD¹, Irving Levine, MD², Dimpal Bhakta, MD³, Matthew McNeill, MD¹, Seth A. Gross, MD, FACG⁴, Melissa Latorre, MD, MS^4
1New York University School of Medicine, New York, NY; ²Hofstra North Shore-LIJ School of Medicine, Manhassett, NY; ³University of Texas Health Science Center at Houston, Houston, TX; ⁴New York University Langone Medical Center, New York, NY

Introduction: Capsule endoscopy (CE) is a novel non-invasive technique for evaluating endoscopy-negative iron deficiency anemia (IDA). CE was historically utilized in the outpatient setting for multiple reasons, however several hospital systems are beginning to adopt inpatient CE. Data comparing inpatient to outpatient CE for evaluation of IDA is lacking.

Methods: We performed a retrospective case-control study comparing patients hospitalized at an urban academic medical center with IDA and suspected occult gastrointestinal bleeding (OGIB) who received outpatient vs inpatient CE. Patients who received outpatient CE were seen from January 2014 to January 2018, after which our institution implemented a protocol for inpatient CE evaluation and acquired a GI hospitalist who could rapidly review video from CE and also perform deep enteroscopy when indicated. Patients who received inpatient CE were seen from February 2018 to October 2019. We collected data on patient demographics, BMI, comorbidities, hospital course, results of CE, and healthcare utilization. The primary outcome was therapeutic yield of CE.

Results: We identified 28 patients hospitalized with IDA and OGIB with negative upper and lower endoscopy who underwent CE in the outpatient setting post-discharge. These patients were matched with 28 patients who received CE during admission (total n=56). Active bleeding was more likely to be visualized on inpatient CE (25 vs 0%, p< 0.01, Table 1), and hemostasis was achieved in 2/7 (29%) of these inpatients on subsequent double-balloon enteroscopy. Time from negative endoscopy to CE was significantly lower in inpatients (1.0 vs. 36.5, p< 0.01). Patients who received inpatient CE had longer lengths of stay (5.50 vs. 4.00, p=0.02). There were no significant differences in demographics, BMI, or completion rate.

Discussion: Active bleeding was more likely to be visualized on inpatient CE. Hemostasis was achieved in a significant group of patients with bleeding identified on CE. The cohort of patients who received inpatient CE had longer LOS. Prospective studies are required to further delineate the impact of inpatient CE on the management of patients with IDA from OGIB.



Disclosures:


Soonwook Hong, MD¹, Saif Laljee, MD¹, Irving Levine, MD², Dimpal Bhakta, MD³, Matthew McNeill, MD¹, Seth A. Gross, MD, FACG⁴, Melissa Latorre, MD, MS⁴. P3004 - Inpatient Capsule Endoscopy of Patients With Iron Deficiency Anemia Is Associated With Higher Therapeutic Yield and Shorter Time From Negative Endoscopy to Evaluation, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.