Safety of capsule endoscopy in the octogenarian as compared with younger patients

Background: There has been an increased use of capsule endoscopy for the evaluation of small-intestine pathology in very elderly patients, yet the safety profile of this procedure has not been well-established. Objective: To estimate the adverse event rate of capsule endoscopy in patients aged ≥80 years and to compare this rate with that of capsule endoscopy patients aged <80 years. Design: Retrospective matched cohort study. Setting: Single tertiary-care referral center. Patients: All 195 patients aged ≥80 years who underwent capsule endoscopy between 2005 and 2011 were included, along with 585 capsule endoscopy patients aged <80 years who were matched by sex in a 1:3 fashion. Intervention: All patients underwent capsule endoscopy and, in selected cases, double-balloon enteroscopy. Main Outcome Measurements: Adverse event rate of capsule endoscopy, which was defined as capsule retention or aspiration. Results: Adverse events occurred at a similar frequency in patients aged ≥80 years compared with those aged <80 years (1.03% vs 0.85%; P = 1.00), resulting in a difference of 0.2% (95% confidence interval, -1.8% to 2.1%). All adverse events were related to capsule retention, with no study patients experiencing aspiration. Limitations: This was a single-center, retrospective study. Conclusion: Adverse events resulting from capsule endoscopy occur at a similar rate in patients aged ≥80 years compared with those aged <80 years. Capsule endoscopy can be performed safely in the very elderly patient population.