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

gastroenterology Report 2014年第4期2卷 300-305页

作者： Mazen Albeldawi Duc Ha Paresh Mehta Rocio Lopez Sunguk Jang Madhusudhan R.Sanaka John J.Vargo Department of gastroenterology and Hepatology Cleveland ClinicClevelandOHUSA Department of Internal Medicine Cleveland ClinicClevelandOHUSA Department of Quantitative Sciences Cleveland ClinicClevelandOHUSA

*** 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.

关键词： acute lower gastro-intestinal bleeding urgent colonoscopy elective colonoscopy outcomes

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