Table 2.
Patient characteristics, indications, and type of procedure in the different studies
| Study | Patient characteristics | Indications | Procedure |
|---|---|---|---|
| Hedge et al. [23] | Cardiac disease: elderly − 46.7%; younger − 28.2% (p = 0.02) Anticoagulation therapy: elderly − 26.7%; younger − 11.8% (p = 0.02) |
Main indication − OGIB: all − 85%; elderly − 96%; younger − 79.6% (p = 0.0008) Abnormal findings on a previous radiologic imaging study: elderly − 3.8%; younger − 14.6% (p = 0.01) |
No significant differences in the mean number of procedures per patient, the percentage of upper/lower DBE procedures, procedure time, and depth of enteroscope insertion between the 2 age groups |
| He et al. [20] | Age-related diseases − 50% 49.2% (n = 29) had blood transfusion |
Main indication − overt OGIB (36/51) Others: abdominal pain (15/51), diarrhea (3/51) |
|
| Byeon et al. [21] | Significant chronic diseases such as ischemic heart disease or COPD − 97.2% ASA class III − 70.6% Anticoagulants or antiplatelet − 42.1% |
Main indication − OGIB (82.7%) | Mean DBE procedure time − 131 ± 51 min |
| Sidhu et al. [27] | Median dose of midazolam: elderly − 4.5 mg; younger − 6 mg (p < 0.001) Median dose of fentanyl: elderly − 50 µg; younger − 75 µg (p = 0.02) Transfusion requirements (number of patients): 10 (<70) vs. 22 (≥70) |
The only indications were OGIB (74% occult and 26% overt) Occult OGIB was the most frequent indication in both groups |
Procedure time was not significantly different between the groups (p = 0.45) |
| Choi et al. [24] | Comorbidities: elderly − 67,6%; younger − 33,9% (p = 0.001) ASA class III: elderly − 20.6%; younger − 2.4% (p = 0.001) NSAID, anticoagulant, or antiplatelet agent use: elderly − 29.4%; younger − 11.3% (p = 0.015) Mean midazolam dose: elderly − 2.61 mg; younger 3.85 mg (p < 0.001) |
Main indication − OGIB: all − 56.3%; elderly − 67.6%; younger − 56.3% (p = 0.17) | No difference in mean total procedure time |
| Cangemi et al. [22] | Comorbidities − 89.2% ASA class III or IV − 90.8% |
Main indication: OGIB (94.9%) | Mean procedure time − 81.1 ± 29.7 min |
| Chen et al. [34] | Main indication − OGIB (36.6%) Next common indication − abdominal pain (29.7%) (NA data of each group) |
||
| Davis-Yadley et al. [25] | ASA class III: all − 80.9%; ≥75 − 69.3%; 65–74 − 66.4%; 55–64 − 68.9%; <55 − 72% (NA statistical significance) CCI: Progressive increase with all older age groups compared with the younger group (p < 0.01) Aspirin and anticoagulant use: all − 41.5%; ≥75 years − 47.6%; 65–74 − 48.8%; 55–64 − 38.9%; <55 − 9.3% (between all older groups and the youngest group, p < 0.05) Transfusion requirements comparing to the <55 group with 22% → 55–64 33.3% (p = 0.04); 65–74 26.1% (p = 0.37) and ≥75 19.1% (p = 0.95) |
Main indication − OGIB: all − 96.4%; ≥75 − 94.1%; 65–74 − 90.8%; 55–64 − 90%; <55 − 58.5% (between all older groups and the youngest group, p < 0.01) Other indications: all − 20.5%; ≥75 years − 5.9%; 65–74 − 9.2%; 55–64 − 10%; <55 − 41.5% (between all older groups and the youngest group, p < 0.001) |
Anterograde SBE: older patients 93–96%; younger − 83.1% (p < 0.05) Retrograde SBE: older patients 5–8.9%; younger − 22% (p < 0.05) |
| Chang et al. [26] | Comorbidities and ASA class III higher in elderly patients (p < 0.05) Elderly patients tended to undergo SBE within 24 h of presentation (emergency setting) (p < 0.05) |
Main indication − OGIB: all − 52.4%; elderly patients − 83.9%; younger − 36.6% (p < 0.001) Unexplained abdominal pain: all − 26.8%; elderly − 8.9%; younger − 35.7% (p < 0.001) Suspicious small-bowel tumor: all − 12.5; elderly − 3.6%; younger − 17% (p = 0.01) |
Anterograde SBE: elderly − 33.9%; younger − 17.0% (p = 0.01) Both approaches: elderly − 46.4%; younger − 63.4% (p = 0.04) Complete SB evaluation: elderly − 45%; younger − 56.5% (p = 0.37) |
| Pinho et al. [19] | Main indication − OGIB (43.3%) (NA data of each group) |
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| Lin et al. [35] | Main indication − OGIB (62.5%) (NA data of each group) |
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| Pattni et al. [28] | Mean midazolam dose: elderly − between 3.7–5.5; younger − 4.6–6.1 (p < 0.001) | Main indication − OGIB (63.8%) (NA data of each group) |
Completion rates did not vary across different ages of patient (p = 0.238) |
| Tao et al. [36] | Main indication − OGIB (34.4%) (NA data of each group) |
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NA, not available; SB, small bowel; DBE, double-balloon enteroscopy; SBE, single-balloon enteroscopy; OGIB, obscure gastrointestinal bleeding; ASA, American Society of Anesthesiologists CCI, Charlson Comorbidity Index; NSAID, nonsteroidal anti-inflammatory drug.