P3445 - Clinical Characteristics and Outcomes in Successful Inpatient Small Bowel Enteroscopy for Gastrointestinal Bleeding

Gary Tan, MD, Omoakhe Tisor, MD, Chun Kit Hung, MD
Northwell Health, Manhasset, NY

Introduction: Small bowel enteroscopy (SBE) enables direct visualization and intervention for small intestinal bleeding. Wireless Video Capsule endoscopy (VCE) is often first performed to guide therapeutic intervention during SBE, frequently as outpatient. Data on patient characteristics associated with successful SBE interventions, and whether inpatient VCE findings can lead to successful endoscopic treatment and affect clinical outcomes are sparse. This study seeks to examine the factors that are associated with successful SBE, and whether inpatient VCE affects clinical outcomes.

Methods: A retrospective study was conducted for patients 18 years or older who underwent SBE for suspected small bowel bleeding between 1/2015 and 7/2022 at Northwell Health. SBE is defined as anterograde small bowel access past the ligament of Treitz via push or single balloon enteroscopy, or retrograde balloon enteroscopy into the ileum. Patient characteristics (antiplatelet or anticoagulant use), clinical course (nadir and admission hemoglobin (Hgb) levels, transfusion requirements, prior VCE findings) were assessed. Findings on SBE and treatment during endoscopic evaluation were collected. Length of stay and 30-day readmission were analyzed. Univariate logistic regression and Chi-Squared testing were performed.

Results: A total of 166 patients had both inpatient VCE and SBE. Out of these subjects, 120 (71.8%) had a positive VCE finding prior to SBE. In 77/120 (64.1%) cases, positive VCE findings were confirmed by SBE. In those with a negative VCE study, a new diagnosis was found on SBE in 13/47 (27.6%). There were no association between the successful and unsuccessful SBE groups for lowest Hgb (OR 0.97, p=.8799), admission Hgb (OR 0.98, p=0.8526), packed red cell transfusions required (OR 0.98, p = 0.1528), use of anticoagulation or antiplatelet agents (RR 0.85, p = 0.2518). The time lapse between VCE and SBE did not impact SBE success (OR=1.07, p=0.1266). Positive inpatient VCE did not impact the overall length of stay (OR=1.00, p=.0968). Successful SBE did not impact readmission (RR 0.81, p=0.46).

Discussion: Inpatient VCE, as well as clinical characteristics including trough Hgb, transfusion requirements, anticoagulation, and time to SBE are not statistically significant predictors of successful SBE. While a positive inpatient VCE led to more SBE being performed, patient outcomes and length of stay do not appear to be affected by positive VCE findings.


Disclosures:


Gary Tan, MD, Omoakhe Tisor, MD, Chun Kit Hung, MD. P3445 - Clinical Characteristics and Outcomes in Successful Inpatient Small Bowel Enteroscopy for Gastrointestinal Bleeding, ACG 2023 Annual Scientific Meeting Abstracts. Vancouver, BC, Canada: American College of Gastroenterology.