Introduction Over the last 13 years, the clinical use of capsule endoscopy (CE) has revolutionised the investigation pathways for the small-bowel. Although non-invasive (as procedure), there are reports of capsule aspiration in certain patient-groups.¹ Moreover, CE video review is a time-consuming process and – on occasions – with limited diagnostic yield (DY). There is scarcity of data on the use of CE in octogenarians.^2–4 We aim to report our centre experience in using CE in octogenarians.

Methods Retrospective study; the SBCE data base of our unit was interrogated for patients >80 years of age who underwent CE. Categorical data are reported as mean ±SD. The Fischer’s exact, the chi-square and the t (unpaired) tests were used to compare datasets. A two-tailed P value of <0.05 was considered statistically significant.

Results 1,477 patients underwent small-bowel CE between 2005 and 2013. 93 CE were performed in 84 (35M/59F) octogenarians; mean age 84 ± 2.9 years. PillCam^®SB1/SB2 and MiroCam^® were used in 61 and 32 CE examinations, respectively. Ten (11.9%) patients had more than 1 CE. One patient was unable to swallow the capsule, and in another the capsule was retained in the stomach. The CE report was unavailable in one case. Indications for small-bowel CE were IDA: 44, OGIB: 29, OBIG+IDA: 6, diarrhoea 4, small-bowel varices: 1. Forty-five (53.6%) patients subsequently died. The mean time from SBCE to death was 23 months (SD 20.9, range: 0.13–83 months).

The DY (all findings) of CE in our octogenarian cohort was 56.8%. Vascular lesions (any P class)/active bleeding were found in 33, inflammatory pathology in 9, and other in 4 CE. No neoplastic pathology was identified. The DY was independent to the indications for the procedure (P = 0.166), the small-bowel CE system used (P = 0.068), the patient final outcome i.e. deceased/alive (P = 0.051) and/or the time from CE to death (P = 0.053).

Conclusion CE in patients >80 years of age has high DY, but sinister pathology in this cohort is rare. Furthermore, small-bowel CE has limited impact on the final patient outcome in this patient group.

References

1. Koulaouzidis A, et al. Small-bowel capsule endoscopy: a ten-point contemporary review. World J Gastroenterol 2013;19:3726–46

2. Koulaouzidis A, et al. The use of small-bowel capsule endoscopy in iron-deficiency anemia alone; be aware of the young anemic patient. Scand J Gastroenterol 2012;47:1094–100

3. Tsibouris P, et al. Capsule endoscopy findings in patients with occult or overt bleeding older than 80 years. Dig Endosc 2012;24:154–8

4. Sidhu R, McAlindon ME. Age should not be a barrier to performing capsule endoscopy in the elderly with anaemia. Dig Dis Sci 2011;56:2497–8

Disclosure of Interest None Declared.