Endoscopy 2015; 47(02): 143-146
DOI: 10.1055/s-0034-1390891
Original article
© Georg Thieme Verlag KG Stuttgart · New York

Factors associated with perforation related to diagnostic balloon-assisted enteroscopy: analysis of a national inpatient database in Japan

Hiroyuki Odagiri
1   Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
,
Hiroki Matsui
1   Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
,
Kiyohide Fushimi
2   Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Tokyo, Japan
,
Mitsuru Kaise
3   Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan
,
Hideo Yasunaga
1   Department of Clinical Epidemiology and Health Economics, School of Public Health, The University of Tokyo, Tokyo, Japan
› Author Affiliations
Further Information

Publication History

submitted 27 March 2014

accepted after revision 16 September 2014

Publication Date:
20 November 2014 (online)

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Background and study aims: Balloon-assisted enteroscopy (BAE) is a well-established procedure that is used worldwide for investigation of the small intestine. Previous reports describing the factors associated with perforation related to diagnostic BAE were limited by inclusion of only small numbers of patients who were mostly treated at a few specialized centers. The aim of this study was to clarify the factors associated with perforation by analysis of a large multicenter database.

Patients and methods: This study retrospectively analyzed data from the Diagnosis Procedure Combination database in Japan. Patients who underwent diagnostic BAE between July 2007 and March 2013 were included. The primary outcome was the occurrence of perforation requiring open surgery. Logistic regression analysis was used to identify factors associated with perforation.

Results: A total of 29 068 patients who underwent diagnostic BAE during the study period were identified. Perforation occurred in 32 patients (0.11 %). Univariable logistic regression analysis showed that patients with inflammatory bowel disease (IBD) on steroids had a significantly higher risk of perforation (odds ratio 8.55; 95 % confidence interval 2.87 – 25.5; P < 0.001). Non-IBD patients on steroids had an approximately three-fold higher risk of perforation compared with patients who were free from IBD and not taking steroids.

Conclusion: Our results suggest that patients with IBD who are using steroids have the highest risk of perforation related to diagnostic BAE.