S1303 Single Balloon Enteroscopy in the Elderly

INTRODUCTION: Single-balloon enteroscopy (SBE) is a minimally invasive technique to evaluate and possibly treat small bowel pathology. The most common usage is to investigate suspected small intestinal bleeding: obscure overt gastrointestinal (GI) bleeding or iron deficiency anemia (IDA). Its safety and feasibility for elderly patients are not well established. We aimed to evaluate the safety and feasibility of SBE in elderly patients. METHODS: We performed a retrospective cohort study of all antegrade and retrograde SBE performed at our academic center from March 2011 through May 2020. We collected data on patient demographics, indications, findings, therapeutic interventions, and complications. The cohort was divided into 3 groups: patients younger than 65 years (group 1), patients 65–75 years old (group 2), and patients older than 75 years (group 3). We used 1-way analysis of variance (ANOVA) and a chi-square test to compare study variables among age groups. The primary aim was to assess diagnostic yield, therapeutic yield and rates of complications from SBE among study groups. RESULTS: A total of 284 SBE were performed in 228 patients. There were 228 antegrade (24 in gastric bypass patients) and 56 retrograde procedures. There were 130 female (57.3%), 128 Hispanic (56.6%) patients, with mean BMI 27.9, and mean age 62.0 - group 1 (117, 51.3%), group 2 (57, 25%) and group 3 (54, 23.7%). Gender, ethnicity, BMI as well as proportions of antegrade and retrograde were similar between age groups. The most common indications, were obscure GI bleeding (50.2%), IDA (48.1%), abdominal pain (13%), abnormal imaging study (2.5%), and diarrhea (1.8%). The elderly were more likely to have the indication of GI bleed (42.6%, 46.6%, 67.1%) (P = 0.002), but there was no difference among groups for IDA (44.1%, 52.1%, 51.3%). The diagnostic yield was significantly higher in the elderly group (46.8%, 56.5%, 68.1%) (P < 0.001). Angioectasias were the most common finding and present more often in the elderly (10.3%, 24.6%, 47.8%) (P < 0.001). Therapeutic interventions were also greater in the elderly group (18.2%, 29.9%, 54.8%) (P < 0.001). There were only 2 (0.9%) complications, including minor oropharyngeal hemorrhage and esophageal trauma and no deaths, with no difference among groups. CONCLUSION: In a retrospective analysis of SBE, we found this procedure to be safe in the elderly with a higher diagnostic and therapeutic yield than in the other age groups, mainly due to the increased finding of small bowel angioectasias.