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.
Published Date: 2021-09-30; Received Date: 2021-09-09