Incomplete small bowel capsule endoscopy: Risk factors and cost-effectiveness of real-time viewing

Background and study aims International guidelines recommend real-time viewing (RTV) in capsule endoscopy for gastric emptying monitoring, yet it is often overlooked in clinical practice. We aimed to assess risk factors for incomplete small bowel capsule endoscopy (SBCE) and evaluate the clinical relevance and cost-effectiveness of RTV implementation. Methods We included consecutive SBCEs from 2013 to 2020. RTV was not applied per local protocol. We used multivariate logistic regression to identify risk factors for incomplete SBCE, including prolonged gastric transit time (GTT) and prolonged small bowel transit time (SBTT). Results Analyzing 858 SBCEs, we observed a completion rate of 94.6%. Prolonged GTT and SBTT were present in 4.9% and 18.2% of complete SBCEs, and in 13% (P=0.03) and 10.8% (P=0.24) of incomplete SBCEs, respectively. Only 0.7% (6 of 858) had incomplete SBCE with prolonged GTT. In both univariate and multivariate analysis, a modifiable (prolonged GTT odds ratio [OR] 2.9; 95% confidence interval [CI] 1.1–7.5) and two unmodifiable risk factors (inpatient status OR 2.3; 95% CI 1.1–4.5) and history of incomplete SBCE (OR 4.2; 95% CI 1.3–13.7) were independently linked to higher incomplete SBCE rates. The pretest completion probability was 90.5% and 95.8% in patients with and without unmodifiable risk factors, respectively (P <0.01). The direct cost of systematic RTV adoption and prokinetics administration would be €5059, aiming to identify and treat each case of prolonged GTT associated with incomplete SBCE. Conclusions Modern devices make incomplete SBCE rare, usually not tied to prolonged GTT. In a low-incidence scenario, widespread RTV use brings high costs and uncertain effectiveness.

Standort
Deutsche Nationalbibliothek Frankfurt am Main
Umfang
Online-Ressource
Sprache
Englisch

Erschienen in
Incomplete small bowel capsule endoscopy: Risk factors and cost-effectiveness of real-time viewing ; volume:12 ; number:07 ; year:2024 ; pages:E842-E848
Endoscopy International Open ; 12, Heft 07 (2024), E842-E848

Beteiligte Personen und Organisationen
Topa, Matilde
Rimondi, Alessandro
Sorge, Andrea
Smania, Veronica
Scaramella, Lucia
Nandi, Nicoletta
Cavallaro, Flaminia
Vecchi, Maurizio
Elli, Luca
Tontini, Gian Eugenio

DOI
10.1055/a-2333-8002
URN
urn:nbn:de:101:1-2408151053194.190811310169
Rechteinformation
Open Access; Der Zugriff auf das Objekt ist unbeschränkt möglich.
Letzte Aktualisierung
14.08.2025, 10:54 MESZ

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Beteiligte

  • Topa, Matilde
  • Rimondi, Alessandro
  • Sorge, Andrea
  • Smania, Veronica
  • Scaramella, Lucia
  • Nandi, Nicoletta
  • Cavallaro, Flaminia
  • Vecchi, Maurizio
  • Elli, Luca
  • Tontini, Gian Eugenio

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