Timing of colonoscopy and outcomes in patients with lower GI bleeding: a nationwide population-based study

Navaneethan, Udayakumar; Njei, Basile; Venkatesh, Preethi G.K.; Sanaka, Madhusudhan R.

doi:10.1016/j.gie.2013.08.001

Cited by 74 publications

(86 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…However, there was no difference in the proportion undergoing endoscopic therapy and no difference in mortality 37. Interestingly, subgroup analysis, limited to patients with a diagnosis of diverticular bleeding, showed no difference in length of stay, mortality or costs with early colonoscopy 37. A recent meta-analysis did not demonstrate any significant difference between early and delayed colonoscopy for the important clinical outcomes of rebleeding or RBC transfusion, but colonoscopy performed within 24 hours was found to significantly increase diagnostic and therapeutic yield and reduce the length of stay 24.…”

Section: Diagnosismentioning

confidence: 85%

“…Multivariate analysis showed that early (<24 hours) colonoscopy reduced length of stay (2.9 vs 4.6 days), transfusion requirements and costs. However, there was no difference in the proportion undergoing endoscopic therapy and no difference in mortality 37. Interestingly, subgroup analysis, limited to patients with a diagnosis of diverticular bleeding, showed no difference in length of stay, mortality or costs with early colonoscopy 37.…”

Section: Diagnosismentioning

confidence: 92%

“…The largest observational study was by Navaneethan et al, who retrospectively analysed 58 296 patients admitted with LGIB in the USA using the inpatient care database 37. Multivariate analysis showed that early (<24 hours) colonoscopy reduced length of stay (2.9 vs 4.6 days), transfusion requirements and costs.…”

Section: Diagnosismentioning

confidence: 99%

See 2 more Smart Citations

Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology

Oakland

Chadwick

East

et al. 2019

Gut

243

241

View full text Add to dashboard Cite

This is the first UK national guideline to concentrate on acute lower gastrointestinal bleeding (LGIB) and has been commissioned by the Clinical Services and Standards Committee of the British Society of Gastroenterology (BSG). The Guidelines Development Group consisted of representatives from the BSG Endoscopy Committee, the Association of Coloproctology of Great Britain and Ireland, the British Society of Interventional Radiology, the Royal College of Radiologists, NHS Blood and Transplant and a patient representative. A systematic search of the literature was undertaken and the quality of evidence and grading of recommendations appraised according to the GRADE(Grading of Recommendations Assessment, Development and Evaluation) methodology. These guidelines focus on the diagnosis and management of acute LGIB in adults, including methods of risk assessment and interventions to diagnose and treat bleeding (colonoscopy, computed tomography, mesenteric angiography, endoscopic therapy, embolisation and surgery). Recommendations are included on the management of patients who develop LGIB while receiving anticoagulants (including direct oral anticoagulants) or antiplatelet drugs. The appropriate use of blood transfusion is also discussed, including haemoglobin triggers and targets.

show abstract

Section: Diagnosismentioning

confidence: 85%

Section: Diagnosismentioning

confidence: 92%

See 1 more Smart Citation

Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology

Oakland

Chadwick

East

et al. 2019

Gut

243

241

View full text Add to dashboard Cite

show abstract

“…Discharge diagnosis of LGIB was ascertained using the International Classification of Diseases 9th revision [ICD-9 CM] codes which includes the various etiologies for LGIB including bleeding diverticulosis (Appendix 1). We based our codes on our previous study on timing of colonoscopy in LGI bleeding and another published study [5, 6]. …”

Section: Methodsmentioning

confidence: 99%

Risk of comorbidities and outcomes in patients with lower gastrointestinal bleeding-a nationwide study

Venkatesh

Njei

Sanaka

et al. 2014

Int J Colorectal Dis

Self Cite

View full text Add to dashboard Cite

Background The impact of comorbidities on outcomes of patients with lower gastrointestinal bleeding (LGIB) remains unknown. Objective Investigate the prevalence of comorbidities and impact on outcomes of patients with LGIB. Methods The Nationwide Inpatient Sample 2010 was used to identify patients who had a primary discharge diagnosis of LGIB based on International Classification of Diseases, the 9th revision, clinical modification codes. The presence of comorbid illness was assessed using the Elixhauser index. Logistic regression models were used to assess the contributions of the individual Elixhauser comorbidities to predict in-hospital mortality. Results A total of 58,296 discharges with LGIB were identified. The overall mortality was 2.3 %. Among the patients who underwent colonoscopy, 17.3 % of patients had therapeutic intervention. As the number of comorbidities increased (i.e., 0, 1, 2, or ≥3), mortality increased (1.7, 2.0, 2.4, and 2.4 %, respectively). The mortality rate was highest in patients >65 years of age (2.7 %). Patients >65 years of age with two or more comorbidities had a mortality rate of 5 % as compared to 2.6 % in those with less than two comorbidities. Congestive heart failure (odds ratio, 1.67 [95 % confidence interval, 1.48–1.95]), liver disease (2.64 [1.83–3.80]), renal failure (1.99 [1.70–2.33]), and weight loss (2.66 [2.27–3.12]) were associated with a significant increase in mortality rate. Comorbidities increased hospital stay and costs. Conclusions Comorbidities were associated with increased the risk of mortality and health care utilization in patients with LGIB. Identification of comorbidities and development of risk-adjustment tools may improve the outcome of patients with LGIB.

show abstract

“…Idealmente el examen se debe hacer en las primeras 24 horas después del inicio del sangrado (16). En este grupo de pacientes las principales causas de sangrado son la colitis isquémica y las úlceras rectales (17).…”

Section: Discussionunclassified

Uso de complejo de protrombina en sangrado digestivo bajo en el paciente crítico anticoagulado. Reporte de caso

Mulett-Vásquez¹,

Marín-Marmolejo²,

Marín-Uribe

2017

Rev Med Hered

View full text Add to dashboard Cite

Se presenta el caso de un varón de 66 años en post-operatorio de cirugía de Bentall y reemplazo de válvula aórtica por prótesis metálica, anticoagulación con warfarina, que presenta un episodio de sangrado digestivo bajo secundario a colitis isquémica localizada con INR elevado, sufriendo descompensación hemodinámica. Se realizó tratamiento con concentrado de protrombina humana con adecuada respuesta.

show abstract

Timing of colonoscopy and outcomes in patients with lower GI bleeding: a nationwide population-based study

Cited by 74 publications

References 17 publications

Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology

Diagnosis and management of acute lower gastrointestinal bleeding: guidelines from the British Society of Gastroenterology

Risk of comorbidities and outcomes in patients with lower gastrointestinal bleeding-a nationwide study

Uso de complejo de protrombina en sangrado digestivo bajo en el paciente crítico anticoagulado. Reporte de caso

Contact Info

Product

Resources

About