Journal d'hépatologie et des troubles gastro-intestinaux
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Utilization of Fecal Occult Blood Testing and its Impact on Endoscopic Procedures in Hospitalized Patients

Vinod Kumar, FNU Jaydev, Jai Khatri, Shobha Shahani

Objective: To gain insights on the impact of fecal occult blood tests, we evaluated inpatients on whom these tests were performed.

Patients and methods: This single center, retrospective study was conducted at a large, academic, tertiary care center. Between Jan 1, 2016-Dec 31, 2017, in patients who developed a drop in hemoglobin ≥ 2 grams/dL and had an FOBT were identified. Further data was extracted on a random selection of half of these patients. Patients were categorized as having an overt GI bleed (symptoms of melena, hematochezia, or hematemesis) or not.

Results: Over the study period 6,310 patients developed a hemoglobin drop of ≥2 grams/dL. Of these 817 (12.9%) had an FOBT and we reviewed 407 (49.8%) randomly selected patients from this group. Those with missing FOBT results (n=13) were excluded, leaving 394 included in the final analysis. The mean age was 62.7 years with 211 females (53.7%). FOBTs were performed in 34.6% of patients despite the presence of overt GI bleeding. In patients without overt GI bleeding, the proportion of patients who underwent endoscopic procedures was higher in those with a positive FOBT than those with negative FOBT (40.4% vs. 13.2%, p<.00001). There were no differences in rates of endoscopic evaluation in patients with overt GI bleeding based on FOBT results.

Conclusion: FOBTs continue to be utilized in inpatient settings including in those presenting with overt GI bleeding. In the absence of overt GI bleeding, positive results may drive endoscopic evaluation.