A38 CLINICAL OUTCOMES OF PATIENTS UNDERGOING BALLOON-ASSISTED ENDOSCOPY FOR OBSCURE GASTROINTESTINAL BLEEDING
Bibliographic record
Abstract
The etiology of gastrointestinal bleeding remains unclear in a sizable minority of patients despite extensive evaluation. In these patients, obscure gastrointestinal bleeding (OGIB) poses a significant diagnostic and therapeutic challenge, resulting in higher patient morbidity and mortality, as well as increased utilization of health care resources. In this study, we evaluate the diagnostic yield and clinical outcomes of patients with OGIB who have undergone balloon-assisted endoscopy (BAE). We performed a large, retrospective cohort study of 311 consecutive patients who underwent BAE at our institution. Of these, 116 cases were identified to have had OGIB and were appropriate for inclusion in our analysis. Follow-up data were available for 110 patients, with median time to follow-up of 6.1 months (range 0.3 – 37.7). The pattern of bleeding, transfusion requirements, and frequency of OGIB control were captured. BAE identified bleeding sources in 79 patient cases (68.1%), of which, 66 (83.5%) had culprit small bowel pathology. Of these, vascular lesions were the most common finding, occurring in 39 patients (59.0%), followed by neoplasia (13.6%, 9 patients), and ulcerations/erosions (12.1%, 8 patients). Diagnostic yield was highest in those patients with active overt bleeding, compared to those with inactive or occult bleeding (80.0%, 20/25 patients vs 35.2%, 32/91 patients). Overall, OGIB was controlled in 58/110 patients (52.7%). Culprit vascular lesions demonstrated poorer control rates than ulcers/erosions, tumors/polyps, or unidentified pathology (38%, 14/37 patients vs 55.8%, 29/52 patients). Among those patients with uncontrolled OGIB, median 6-month red-cell transfusion requirements were lower post-procedure compared to those pre-procedure (0.69 units/month, range 0.00 – 50.7; vs 1.00 units/month, range 0.00 – 10.3). BAE is a useful diagnostic and therapeutic strategy in the management of patients with OGIB. Luminal evaluation of the small bowel with BAE should be undertaken as soon as OGIB is suspected, and preferably in proximity to active bleeding. Vascular lesions are particularly recalcitrant to endoscopic therapy and therefore warrant close monitoring. Outcomes for patients with OGIB after undergoing BAE Controlled OGIB is defined as the clinically stable condition meeting the following criteria: (1) the absence of any overt re-bleeding, (2) no further requirement of red cell transfusions, and (3) the resolution or absence of persistent anemia. None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".