IS CAPSULE ENDOSCOPY SMALL BOWEL ANGIODYSPLASIA ACTIVITY INDEX (CESBAI) CAPABLE OF PREDICTING REBLEEDING AND NEED FOR ENDOSCOPIC TREATMENT IN PATIENTS WITH SUSPECTED SMALL BOWEL BLEEDING?

Aims The Capsule Endoscopy Small Bowel Angiodysplasia Activity Index (CESBAI) is a recently created score for small bowel angiodysplasias (SBAD) evaluation in patients with suspected small bowel bleeding (SBB), including 3 variables: extension, number and bleeding probability of SBAD. Although having a low interobserver variability, it is still unknown if it could be used in the prediction of rebleeding and need for endoscopic treatment after initial capsule endoscopy (CE). We aimed to evaluate the performance of CESBAI for these outcomes. Methods Retrospective cohort-study including complete CE for SSB with a SBAD diagnosis, from May2008-October2020. The minimum follow-up was 12 months. CE with any other vascular and nonvascular lesions that could be a source of bleeding were excluded. Rebleeding was defined as an overt bleeding event (melaenas or hematochezia) or a decrease of≥2g/dL in hemoglobin level. The score was calculated and its accuracy for the prediction of rebleeding and need for endoscopic treatment was assessed through a receiver operating characteristic curve. Results Data from 125 patients was included. Rebleeding occurred in 48 (38.4%) patients and 35 (28.0%) patients were submitted to endoscopic treatment during a mean follow-up of 55±36 months. Most frequent CESBAI score was 6 (40,2%) and 9 (31,1%). The score showed a fair and acceptable accuracy predicting rebleeding (C-statistic 0.650; 95%CI [0.550-0.750]; p<0.05) and endoscopic treatment (C-statistic 0.720; 95%CI [0.619-0.820];p<0.001), respectively. Conclusions Even though its performance was not outstanding, application of the CESBAI in patients with SSB from SBAD can be considered in order to predict rebleeding risk and endoscopic treatment. Publication History Article published online: 14 April 2022 © 2022. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Rüdigerstraße 14, 70469 Stuttgart, Germany