Differences in emergency endoscopy outcomes according to gastrointestinal bleeding location
| Autor: | Akiko Shiotani, Minoru Fujita, Noriaki Manabe, Tomohiro Tanikawa, Motoyasu Osawa, Takahisa Murao, Ken Haruma, Shogen Yo, Mitsuhiko Suehiro, Maki Ayaki, Hirofumi Kawamoto, Shinya Fukushima, Takako Sasai, Jun Nakamura |
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| Rok vydání: | 2020 |
| Předmět: |
medicine.medical_specialty
Gastrointestinal bleeding Lower gastrointestinal bleeding Risk Assessment Severity of Illness Index Endoscopy Gastrointestinal 03 medical and health sciences Endoscopic hemostasis 0302 clinical medicine medicine Humans Glasgow-Blatchford score Retrospective Studies medicine.diagnostic_test business.industry General surgery Hemostasis Endoscopic Gastroenterology Clinical course Endoscopy medicine.disease 030220 oncology & carcinogenesis 030211 gastroenterology & hepatology Upper gastrointestinal bleeding Gastrointestinal Hemorrhage business |
| Zdroj: | Scandinavian Journal of Gastroenterology. 56:86-93 |
| ISSN: | 1502-7708 0036-5521 |
| DOI: | 10.1080/00365521.2020.1847316 |
| Popis: | With recent technological advances in the field of endoscopic hemostasis, the prognosis of patients with gastrointestinal (GI) bleeding has improved. However, few studies have reported on the clinical course of patients with GI bleeding. This study aimed to evaluate the differences in clinical outcomes of patients with lower GI bleeding (LGIB) compared with upper GI bleeding (UGIB) and the factors related to their prognosis.Patients who had undergone emergency endoscopy for GI bleeding were retrospectively reviewed. The severity of GI bleeding was evaluated using the Glasgow-Blatchford (GB), AIMS65, and NOBLADS scores. Patients in whom obvious GI bleeding relapsed and/or iron deficiency anemia persisted after emergency endoscopy were considered to exhibit rebleeding.We reviewed 1697 consecutive patients and divided them into UGIB (1054 patients) and LGIB (643 patients) groups. The proportion of patients with rebleeding was significantly greater in the UGIB group than in the LGIB group; the mortality rate was significantly higher in the UGIB group than in the LGIB group. Multivariate analysis showed that a GB score ≥12 and an AIMS65 score ≥2 were significantly associated with rebleeding in the UGIB group, whereas a NOBLADS score ≥4 was significantly associated with rebleeding in the LGIB group. Notably, the influence of emergency endoscopy differed according to GI bleeding location.The clinical course was significantly worse in patients with UGIB than in patients with LGIB. The influence of emergency endoscopy differed according to GI bleeding location. |
| Databáze: | OpenAIRE |
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