Objective Small-bowel capsule endoscopy (SBCE) is being used with increasing frequency. It is important, however, to ensure that the frail elderly in particular are undergoing investigations which have a positive impact on their ongoing management. We aimed to determine the SBCE rate in the elderly, the clinical outcomes, and if clinical frailty may be used to tailor SBCE. Design/methods Patients aged ≥65 who had a SBCE performed at the Royal Infirmary of Edinburgh from 1 January 2016 to 1 December 2021 were identified. Demographic, clinical and SBCE results were collected and statistical analysis was performed. Results In total, 189 patients aged ≥65 years underwent SBCE. Median age at SBCE was 72 years (IQR 68–76); 63.0% (n=119) were women. The most common indication for SBCE was iron-deficiency anaemia (n=174, 92.1%). A total of 15.9% (n=30) patients were clinically frail (Clinical Frailty Scale ≥5). Frail patients had reduced survival at 1 (p=0.003), 3 (p<0.001) and 5 (p<0.0001) years post-SBCE. The most common pathology in this group was angioectasia (33.3%, n=10). Double balloon enteroscopy was performed in 1 frail patient, compared with 11 non-frail patients (p=0.488). Conclusions Our results indicate that small bowel bleeding in the frail elderly is most likely to be associated with angioectasia. Given the high mortality at follow-up and risks of subsequent investigations in this group, conservative treatment with oral or parenteral iron may be more appropriate. Investigating these patients with SBCE is unlikely to alter management and clinical outcome. Data are available upon reasonable request.

中文翻译：

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虚弱老年患者接受小肠胶囊内窥镜检查的临床结局


目的 小肠胶囊内窥镜检查 （SBCE） 的使用频率越来越高。然而，重要的是要确保特别是体弱的老年人正在接受检查，这对他们的持续管理有积极影响。我们旨在确定老年人的 SBCE 发生率、临床结局以及临床虚弱是否可以用于定制 SBCE。设计/方法 确定了 2016 年 1 月 1 日至 2021 年 12 月 1 日在爱丁堡皇家医院进行 SBCE 的 ≥ 岁 65 岁患者。收集人口统计学、临床和 SBCE 结果并进行统计分析。结果 共有 189 例年龄≥ 65 岁的患者接受了 SBCE。SBCE 的中位年龄为 72 岁 （IQR 68-76）;63.0% （n=119） 为女性。SBCE 最常见的适应证是缺铁性贫血 （n=174， 92.1%）。共有 15.9% （n=30） 的患者临床虚弱 （临床虚弱量表 ≥5）。虚弱患者在 SBCE 后 1 年 （p=0.003） 、 3 年 （p<0.001） 和 5 年 （p<0.0001） 的生存率降低。该组最常见的病理是血管扩张症 （33.3%，n=10）。与 11 名非虚弱患者相比，1 名虚弱患者进行了双球囊小肠镜检查 （p=0.488）。结论 我们的结果表明，体弱老年人的小肠出血最有可能与血管扩张有关。鉴于该组患者的高随访死亡率和后续检查的风险，口服或肠外铁剂的保守治疗可能更合适。对这些 SBCE 患者进行调查不太可能改变管理和临床结局。数据可根据合理要求提供。