ORIGINAL ARTICLE: Clinical Endoscopy Timing of video capsule endoscopy relative to overt obscure GI bleeding: implications from a retrospective study Anupam Singh, MD, Christopher Marshall, MD, Biswashree Chaudhuri, MD, Chidimma Okoli, MD, Anne Foley, BA, Sharina D. Person, PhD, Kanishka Bhattacharya, MD, David R. Cave, MD, PhD Worcester, Massachusetts, USA Background: Diagnostic yield of video capsule endoscopy (VCE) may be higher if it is performed closer to the time of overt obscure GI bleeding (OOGIB). Objective: To evaluate the diagnostic yield of VCE and rate of therapeutic intervention for OOGIB for inpatients and outpatients with respect to timing of the intervention. Design: Retrospective cohort study. Setting: Tertiary academic center. Patients: Patients who had VCE for OOGIB between August 2008 and August 2010. Interventions: VCE for inpatients versus outpatients. Main Outcome Measures: Diagnostic yield and rate of therapeutic intervention for inpatients versus outpatients. Results: One hundred forty-four inpatients (65 women) and 116 outpatients (49 women) were included. Diagnostic yield was 65.9% for inpatients versus 53.4% for outpatients (P = .054). Inpatients were divided into those who had VCE within 3 days (3 days; n = 90) of admission versus after 3 days (3 days; n = 54). Active bleeding and/or an angioectasia was found in 44.4% of the 3-day group compared with 27.8% of the 3-day group (P = .046) versus 25.8% of the outpatients. Therapeutic intervention was performed in 18.9% of the 3-day group versus 7.4% of the 3-day group (P = .046) versus 10.3% of outpatients. Diagnostic yield and therapeutic intervention rate between the 3-day group and outpatients were not significantly different. Length of stay (days) was less in the 3-day cohort, at 6.1 versus 10.3 in the 3-day cohort (P  .0001). Limitations: Long-term outcomes were not studied. This was a retrospective study. Conclusions: Early deployment of VCE within 3 days of admission results in a higher diagnostic yield and therapeutic intervention rate and an associated reduction of length of stay. ( Gastrointest Endosc 2013;77:761-6.) Abbreviations: OGIB, obscure GI bleeding; OOGIB, overt obscure GI bleeding; VCE, video capsule endoscopy. DISCLOSURE: The following authors disclosed financial relationships rele- vant to this publication: S D Person was partially supported by the National Center for Advancing Translational Sciences of the National Institutes of Health under award numbers UL1RR031982 and UL1TR000161. The con- tent is solely the responsibility of the author and does not necessarily repre- sent the official views of the National Institutes of Health. Otherwise this was an investigator-initiated study with no external funding. K Bhattacharya: research consultant in deep enteroscopy for Olympus Corp. D R Cave: research support consultant in video capsule endoscopy for Olympus Corp.; research support for Capsovision. All other authors disclosed no financial relationships relevant to this publication. Use your mobile device to scan this QR code and watch the author inter- view. Download a free QR code scan- ner by searching ‘QR Scanner’ in your mobile device’s app store. Copyright © 2013 by the American Society for Gastrointestinal Endoscopy 0016-5107/$36.00 http://dx.doi.org/10.1016/j.gie.2012.11.041 Received September 27, 2012. Accepted November 29, 2012. Current affiliations: University of Massachusetts Memorial Medical Center, Worcester, Massachusetts, USA. Reprint requests: Anupam Singh, MD, Division of Gastroenterology, UMass Memorial Medical Center, 55 Lake Ave North, Worcester, MA 01655. www.giejournal.org Volume 77, No. 5 : 2013 GASTROINTESTINAL ENDOSCOPY 761