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Effectiveness of early colonoscopy in patients with colonic diverticular hemorrhage: A single-center retrospective cohort study
BACKGROUND: Current guidelines recommend colonoscopy within 24 h for acute lower gastrointestinal bleeding; however, the evidence in support for colonic diverticular hemorrhage (CDH) indications remains insufficient. AIM: To investigate the effectiveness of early colonoscopy on the length of hospita...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Baishideng Publishing Group Inc
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782567/ https://www.ncbi.nlm.nih.gov/pubmed/36567825 http://dx.doi.org/10.4253/wjge.v14.i12.759 |
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author | Ichita, Chikamasa Shimizu, Sayuri Sasaki, Akiko Sumida, Chihiro Nishino, Takashi Kimura, Karen |
author_facet | Ichita, Chikamasa Shimizu, Sayuri Sasaki, Akiko Sumida, Chihiro Nishino, Takashi Kimura, Karen |
author_sort | Ichita, Chikamasa |
collection | PubMed |
description | BACKGROUND: Current guidelines recommend colonoscopy within 24 h for acute lower gastrointestinal bleeding; however, the evidence in support for colonic diverticular hemorrhage (CDH) indications remains insufficient. AIM: To investigate the effectiveness of early colonoscopy on the length of hospital stay for CDH patients. METHODS: We conducted a single-center retrospective cohort study. Patients who underwent colonoscopy within 24 h of presentation (early group) were compared with those who underwent colonoscopy beyond 24 h of presentation (elective group). The primary outcome was the length of hospital stay, and secondary outcomes were the identification of stigmata of recent hemorrhage (SRH), rebleeding, red blood cell transfusion more than 4 units, and interventional radiology and abdominal surgery after colonoscopy. RESULTS: We identified 574 CDH cases. Patients were divided into the early (n = 328) and elective (n = 226) groups. After propensity score matching, 191 pairs were generated. The length of hospital stay did not significantly differ between the two groups (early group vs elective group; median, 7 vs 8 d; P = 0.10). The early group had a significantly high identification of SRH (risk difference, 11.6%; 95%CI: 2.7 to 20.3; P = 0.02). No significant differences were found in the rebleeding (risk difference, 4.7%; 95%CI: -4.1 to 13.5; P = 0.35), red blood cell transfusion more than 4 units (risk difference, 1.6%; 95%CI: -7.5 to 10.6; P = 0.82), and interventional radiology and abdominal surgery rate after colonoscopy (risk difference, 0.5%; 95%CI: -2.2 to 3.2; P = 1.00). CONCLUSION: Early colonoscopy within 24 h, on arrival for CDH, could not improve the length of hospital stay. |
format | Online Article Text |
id | pubmed-9782567 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Baishideng Publishing Group Inc |
record_format | MEDLINE/PubMed |
spelling | pubmed-97825672022-12-24 Effectiveness of early colonoscopy in patients with colonic diverticular hemorrhage: A single-center retrospective cohort study Ichita, Chikamasa Shimizu, Sayuri Sasaki, Akiko Sumida, Chihiro Nishino, Takashi Kimura, Karen World J Gastrointest Endosc Retrospective Cohort Study BACKGROUND: Current guidelines recommend colonoscopy within 24 h for acute lower gastrointestinal bleeding; however, the evidence in support for colonic diverticular hemorrhage (CDH) indications remains insufficient. AIM: To investigate the effectiveness of early colonoscopy on the length of hospital stay for CDH patients. METHODS: We conducted a single-center retrospective cohort study. Patients who underwent colonoscopy within 24 h of presentation (early group) were compared with those who underwent colonoscopy beyond 24 h of presentation (elective group). The primary outcome was the length of hospital stay, and secondary outcomes were the identification of stigmata of recent hemorrhage (SRH), rebleeding, red blood cell transfusion more than 4 units, and interventional radiology and abdominal surgery after colonoscopy. RESULTS: We identified 574 CDH cases. Patients were divided into the early (n = 328) and elective (n = 226) groups. After propensity score matching, 191 pairs were generated. The length of hospital stay did not significantly differ between the two groups (early group vs elective group; median, 7 vs 8 d; P = 0.10). The early group had a significantly high identification of SRH (risk difference, 11.6%; 95%CI: 2.7 to 20.3; P = 0.02). No significant differences were found in the rebleeding (risk difference, 4.7%; 95%CI: -4.1 to 13.5; P = 0.35), red blood cell transfusion more than 4 units (risk difference, 1.6%; 95%CI: -7.5 to 10.6; P = 0.82), and interventional radiology and abdominal surgery rate after colonoscopy (risk difference, 0.5%; 95%CI: -2.2 to 3.2; P = 1.00). CONCLUSION: Early colonoscopy within 24 h, on arrival for CDH, could not improve the length of hospital stay. Baishideng Publishing Group Inc 2022-12-16 2022-12-16 /pmc/articles/PMC9782567/ /pubmed/36567825 http://dx.doi.org/10.4253/wjge.v14.i12.759 Text en ©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved. https://creativecommons.org/licenses/by-nc/4.0/This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. |
spellingShingle | Retrospective Cohort Study Ichita, Chikamasa Shimizu, Sayuri Sasaki, Akiko Sumida, Chihiro Nishino, Takashi Kimura, Karen Effectiveness of early colonoscopy in patients with colonic diverticular hemorrhage: A single-center retrospective cohort study |
title | Effectiveness of early colonoscopy in patients with colonic diverticular hemorrhage: A single-center retrospective cohort study |
title_full | Effectiveness of early colonoscopy in patients with colonic diverticular hemorrhage: A single-center retrospective cohort study |
title_fullStr | Effectiveness of early colonoscopy in patients with colonic diverticular hemorrhage: A single-center retrospective cohort study |
title_full_unstemmed | Effectiveness of early colonoscopy in patients with colonic diverticular hemorrhage: A single-center retrospective cohort study |
title_short | Effectiveness of early colonoscopy in patients with colonic diverticular hemorrhage: A single-center retrospective cohort study |
title_sort | effectiveness of early colonoscopy in patients with colonic diverticular hemorrhage: a single-center retrospective cohort study |
topic | Retrospective Cohort Study |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9782567/ https://www.ncbi.nlm.nih.gov/pubmed/36567825 http://dx.doi.org/10.4253/wjge.v14.i12.759 |
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