Your browser doesn't support javascript.
loading
Efficacy of urgent colonoscopy for colonic diverticular bleeding: A propensity score-matched analysis using a nationwide database in Japan.
Moroi, Rintaro; Tarasawa, Kunio; Shiga, Hisashi; Yano, Kota; Shimoyama, Yusuke; Kuroha, Masatake; Kakuta, Yoichi; Fushimi, Kiyohide; Fujimori, Kenji; Kinouchi, Yoshitaka; Masamune, Atsushi.
Afiliação
  • Moroi R; Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Tarasawa K; Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Shiga H; Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Yano K; Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Shimoyama Y; Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Kuroha M; Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Kakuta Y; Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Fushimi K; Department of Health Policy and Informatics, Tokyo Medical and Dental University Graduate School of Medicine, Bunkyo, Japan.
  • Fujimori K; Department of Health Administration and Policy, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Kinouchi Y; Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • Masamune A; Division of Gastroenterology, Department of Internal Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
J Gastroenterol Hepatol ; 36(6): 1598-1604, 2021 Jun.
Article em En | MEDLINE | ID: mdl-33119929
BACKGROUND AND AIM: Although colonic diverticular bleeding (CDB) is considered to have good prognosis with conservative therapy, some cases are severe. The efficacy of urgent colonoscopy for CDB and clinical factors affecting CDB prognosis are unclear. This study aimed to evaluate the efficacy of urgent colonoscopy for CDB and identify risk factors for unfavorable events, including in-hospital death during admission, owing to CDB. METHODS: We collected CDB patients' data using the Diagnosis Procedure Combination database system. We divided eligible patients into urgent and elective colonoscopy groups using propensity score matching and compared endoscopic hemostasis and in-hospital death rates and length of hospital stay. We also conducted logistic regression analysis to identify clinical factors affecting CBD clinical events, including in-hospital death, a relatively rare CDB complication. RESULTS: Urgent colonoscopy reduced the in-hospital death rate (0.35% vs 0.58%, P = 0.033) and increased the endoscopic hemostasis rate (3.0% vs 1.7%, P < 0.0001) compared with elective colonoscopy. Length of hospitalization was shorter in the urgent than in the elective colonoscopy group (8 vs 9 days, P < 0.0001). Multivariate analysis also revealed that urgent colonoscopy reduced in-hospital death (odds ratio = 0.67, 95% confidence interval: 0.46-0.97, P = 0.036) and increased endoscopic hemostasis (odds ratio = 1.84, 95% confidence interval: 1.53-2.22, P <  0.0001). CONCLUSION: Urgent colonoscopy for CDB may facilitate identification of the bleeding site and reduce in-hospital death. The necessity and appropriate timing of urgent colonoscopy should be considered based on patients' condition.
Assuntos
Palavras-chave

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Bases de Dados Factuais / Divertículo do Colo / Hemorragia Gastrointestinal Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Bases de Dados Factuais / Divertículo do Colo / Hemorragia Gastrointestinal Tipo de estudo: Etiology_studies / Prognostic_studies / Risk_factors_studies Limite: Aged / Female / Humans / Male / Middle aged País como assunto: Asia Idioma: En Ano de publicação: 2021 Tipo de documento: Article