Utility of urgent colonoscopy in acute lower gastro-intestinal bleeding:a single-center experience

作     者：Mazen Albeldawi Duc Ha Paresh Mehta Rocio Lopez Sunguk Jang Madhusudhan R.Sanaka John J.Vargo 

作者机构：Department of Gastroenterology and HepatologyCleveland ClinicClevelandOHUSA Department of Internal MedicineCleveland ClinicClevelandOHUSA Department of Quantitative SciencesCleveland ClinicClevelandOHUSA 

出 版 物：《Gastroenterology Report》 (胃肠病学报道（英文）)

年 卷 期：2014年第2卷第4期

页      面：300-305页

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：acute lower gastro-intestinal bleeding urgent colonoscopy elective colonoscopy outcomes 

摘      要：*** role of urgent colonoscopy in lower gastro-intestinal bleeding(LGIB)remains *** the last two decades,a number of studies have indicated that urgent colonoscopy may facilitate the identification and treatment of bleeding lesions;however,studies comparing this approach to elective colonoscopy for LGIB are *** determine the utility and assess the outcome of urgent colonoscopy as the initial test for patients admitted to the intensive care unit(ICU)with acute *** patients who underwent colonoscopy at our institution for the initial evaluation of acute LGIB between January 2011 and January 2012 were analysed *** were grouped into urgent *** colonoscopy,depending on the timing of colonoscopy after admission to the *** colonoscopy was defined as being performed within 24 hours of admission and those performed later than 24 hours were considered *** included length of hospital stay,early re-bleeding rates,and the need for additional diagnostic or therapeutic *** logistic regression analysis was performed to identify factors associated with increased transfusion ***-seven patients underwent colonoscopy for the evaluation of suspected LGIB,24 of which were *** was no significant difference in patient demographics,co-morbidities,or medications between the two *** who underwent urgent colonoscopy were more likely to present with hemodynamic instability(P=0.019)and require blood transfusions(P=0.003).No significant differences in length of hospital stay,re-bleeding rates,or the need for additional diagnostic or therapeutic interventions were *** requiring blood transfusions(n=27)were more likely to be female(P=0.016)and diabetics(P=0.015).Fourteen patients re-bled at a median of 2 days after index *** with hemodynamic instability were more likely to re-bleed[HR 3.8(CI 1.06–13.