Springer Nature
Journal of Gastroenterology
,  volume 60 ,  issue 2 ,  pages 174-186

Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study

Kazuyuki Narimatsu 1
, 
Naoki Ishii 2
, 
Atsuo Yamada 3
, 
Tomonori Aoki 3
, 
Katsumasa Kobayashi 4
, 
Atsushi Yamauchi 5
, 
Jun Omori 6
, 
Takashi Ikeya 7
, 
Taiki Aoyama 8
, 
Naoyuki Tominaga 9
, 
Yoshinori Sato 10
, 
Takaaki Kishino 11
, 
Tsunaki Sawada 12
, 
Masaki Murata 13
, 
Akinari Takao 14
, 
Kazuhiro Mizukami 15
, 
Ken Kinjo 16
, 
Shunji Fujimori 17
, 
Takahiro Uotani 18
, 
Minoru Fujita 19
, 
Hiroki SATO 20
, 
Sho Suzuki 21
, 
Toshiaki Narasaka 22, 23
, 
Junnosuke Hayasaka 24
, 
Tomohiro Funabiki 25, 26
, 
Yuzuru Kinjo 27
, 
Akira Mizuki 28
, 
Shu Kiyotoki 29
, 
Tatsuya Mikami 30
, 
Ryosuke Gushima 31
, 
Hiroyuki FUJII 32
, 
Yuta Fuyuno 33
, 
Takuto Hikichi 34
, 
Yosuke Toya 35
, 
Noriaki Manabe 36
, 
Koji Nagaike 37
, 
Tetsu Kinjo 38
, 
Yorinobu Sumida 39
, 
Sadahiro Funakoshi 40
, 
Kiyonori Kobayashi 41
, 
Tamotsu Matsuhashi 42
, 
Yuga Komaki 43
, 
Ryota Hokari 1
, 
Mitsuru Kaise 6
, 
Naoyoshi Nagata 44, 45
1
 
2
 
Division of Gastroenterology, Tokyo Shinagawa Hospital, Shinagawa-ku, Japan | 
3
 
4
 
Department of Gastroenterology, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Japan | 
5
 
6
 
7
 
8
 
Department of Gastroenterology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan | 
9
 
Department of Gastroenterology, Saga-Ken Medical Centre Koseikan, Saga, Japan | 
10
 
11
 
Department of Gastroenterology and Hepatology, Center for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan | 
12
 
13
 
14
 
15
 
16
 
17
 
18
 
Department of Gastroenterology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan | 
19
 
20
 
21
 
22
 
23
 
24
 
Department of Gastroenterology, Toranomon Hospital, Minato-ku, Japan | 
25
 
26
 
Emergency and Critical Care Center, Saiseikai Yokohamashi Tobu Hospital, Kanagawa, Japan | 
27
 
Department of Gastroenterology, Naha City Hospital, Okinawa, Japan | 
28
 
Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Minato-ku, Japan | 
29
 
Department of Gastroenterology, Shuto General Hospital, Yamaguchi, Japan | 
30
 
31
 
32
 
Department of Gastroenterology and Hepatology, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan | 
33
 
34
 
35
 
36
 
37
 
Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Osaka, Japan | 
38
 
39
 
Department of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan | 
40
 
41
 
42
 
43
 
44
 
45
 
Publication type: Journal Article
Publication date: 2024-12-27
Springer Nature
scimago Q1
wos Q1
SJR: 2.136
CiteScore: 12.1
Impact factor: 5.5
ISSN: 09441174, 14355922
Abstract
Despite accumulating evidence and recommendations for management of colonic diverticular bleeding (CDB), the changes in its clinical management and outcomes remain unknown. We performed a retrospective tendency analysis on a biennial basis, a propensity score-matched cohort study between the first and latter half groups, and mediation analyses to compare the diagnostic and treatment methods between January 2010 and December 2019 (CODE BLUE-J Study). A total of 6575 patients with CDB were included. While the use of colonoscopy as the initial diagnostic procedure declined, the use of computed tomography (CT) increased in both the trend test and before-and-after comparisons. In hemostasis therapy, the use of endoscopic clips declined and band ligation increased. Interventional radiology remained unchanged; however, the number of surgeries decreased over time. The stigmata of recent hemorrhage (SRH) detection rate and length of hospital stay (LOS) improved significantly. Mediation analyses showed that use of a distal attachment and water-jet scope contributed to an improved SRH detection rate, and use of band ligation contributed to preventing rebleeding within 30 days. Management strategies for CDB have changed in the past decade, particularly regarding the increased use of CT and decreased need for surgery. However, the main outcomes, except for the SRH detection rate and LOS, did not improve. The widespread use of distal attachment, water-jet scope, and band ligation could improve outcomes in CDB management.
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Narimatsu K. et al. Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study // Journal of Gastroenterology. 2024. Vol. 60. No. 2. pp. 174-186.
GOST all authors (up to 50) Copy
Narimatsu K. et al. Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study // Journal of Gastroenterology. 2024. Vol. 60. No. 2. pp. 174-186.
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RIS Copy
TY - JOUR
DO - 10.1007/s00535-024-02178-9
UR - https://link.springer.com/10.1007/s00535-024-02178-9
TI - Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study
T2 - Journal of Gastroenterology
AU - Narimatsu, Kazuyuki
AU - Ishii, Naoki
AU - Yamada, Atsuo
AU - Aoki, Tomonori
AU - Kobayashi, Katsumasa
AU - Yamauchi, Atsushi
AU - Omori, Jun
AU - Ikeya, Takashi
AU - Aoyama, Taiki
AU - Tominaga, Naoyuki
AU - Sato, Yoshinori
AU - Kishino, Takaaki
AU - Sawada, Tsunaki
AU - Murata, Masaki
AU - Takao, Akinari
AU - Mizukami, Kazuhiro
AU - Kinjo, Ken
AU - Fujimori, Shunji
AU - Uotani, Takahiro
AU - Fujita, Minoru
AU - SATO, Hiroki
AU - Suzuki, Sho
AU - Narasaka, Toshiaki
AU - Hayasaka, Junnosuke
AU - Funabiki, Tomohiro
AU - Kinjo, Yuzuru
AU - Mizuki, Akira
AU - Kiyotoki, Shu
AU - Mikami, Tatsuya
AU - Gushima, Ryosuke
AU - FUJII, Hiroyuki
AU - Fuyuno, Yuta
AU - Hikichi, Takuto
AU - Toya, Yosuke
AU - Manabe, Noriaki
AU - Nagaike, Koji
AU - Kinjo, Tetsu
AU - Sumida, Yorinobu
AU - Funakoshi, Sadahiro
AU - Kobayashi, Kiyonori
AU - Matsuhashi, Tamotsu
AU - Komaki, Yuga
AU - Hokari, Ryota
AU - Kaise, Mitsuru
AU - Nagata, Naoyoshi
PY - 2024
DA - 2024/12/27
PB - Springer Nature
SP - 174-186
IS - 2
VL - 60
PMID - 39730771
SN - 0944-1174
SN - 1435-5922
ER -
BibTex |
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BibTex (up to 50 authors) Copy
@article{2024_Narimatsu,
author = {Kazuyuki Narimatsu and Naoki Ishii and Atsuo Yamada and Tomonori Aoki and Katsumasa Kobayashi and Atsushi Yamauchi and Jun Omori and Takashi Ikeya and Taiki Aoyama and Naoyuki Tominaga and Yoshinori Sato and Takaaki Kishino and Tsunaki Sawada and Masaki Murata and Akinari Takao and Kazuhiro Mizukami and Ken Kinjo and Shunji Fujimori and Takahiro Uotani and Minoru Fujita and Hiroki SATO and Sho Suzuki and Toshiaki Narasaka and Junnosuke Hayasaka and Tomohiro Funabiki and Yuzuru Kinjo and Akira Mizuki and Shu Kiyotoki and Tatsuya Mikami and Ryosuke Gushima and Hiroyuki FUJII and Yuta Fuyuno and Takuto Hikichi and Yosuke Toya and Noriaki Manabe and Koji Nagaike and Tetsu Kinjo and Yorinobu Sumida and Sadahiro Funakoshi and Kiyonori Kobayashi and Tamotsu Matsuhashi and Yuga Komaki and Ryota Hokari and Mitsuru Kaise and Naoyoshi Nagata and others},
title = {Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study},
journal = {Journal of Gastroenterology},
year = {2024},
volume = {60},
publisher = {Springer Nature},
month = {dec},
url = {https://link.springer.com/10.1007/s00535-024-02178-9},
number = {2},
pages = {174--186},
doi = {10.1007/s00535-024-02178-9}
}
MLA
Cite this
MLA Copy
Narimatsu, Kazuyuki, et al. “Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study.” Journal of Gastroenterology, vol. 60, no. 2, Dec. 2024, pp. 174-186. https://link.springer.com/10.1007/s00535-024-02178-9.