Video capsule endoscopy safe, with higher diagnostic yield in 80-, 90-year-olds

Video capsule endoscopy (VCE) is as safe in octa-nonagenarians as it is in younger older-adults, a recent study has found. At the same time, diagnostic yield seems to be better in this older subgroup.

Researchers conducted a retrospective analysis of 535 VCE procedures in 499 older adult patients. Majority (82.8 percent) of participants were aged 65–79 years, while 17.2 percent were ≥80 years of age. Outcomes included diagnostic yield, capsule transit time, and indications for referral, all compared between age subgroups.

Clinically significant findings from VCE were more common in the older vs younger subgroup (52.7 percent vs 40.0 percent; p=0.025), as were any VCE findings (67.0 percent vs 51.5 percent; p=0.007). The most common findings were bleeding or non-bleeding angioectasia, which was also detected significantly more frequently in the older group (36.0 percent vs 23.4 percent; p=0.014).

Similarly, active bleeding was detected by VCE at a higher rate in ≥80-year-olds (12.5 percent vs 6.5 percent; p=0.053).

Majority of procedures (96.3 percent) ended in complete small bowel (SB) endoscopy, with completion rates being similar between age groups (p=0.132). Gastric (p=0.775) and SB (p=0.635) capsule transit times also did not significantly differ between groups.

“Due to the significant findings in the colon and stomach, we would suggest assuring high quality negative upper and lower endoscopy before VCE, but also reading the entire recording including the stomach and colon for unsuspected severe pathologies even though the algorithm of SB-VCE is designed for investigating only the SB,” the researchers said.