Timing of colonoscopy in acute lower GI bleeding: a multicenter retrospective cohort study
Yasutoshi Shiratori
,
Naoki Ishii
,
Tomonori Aoki
,
Katsumasa Kobayashi
,
Atsushi Yamauchi
,
Atsuo Yamada
,
Jun Omori
,
Taiki Aoyama
,
Naoyuki Tominaga
,
Yoshinori Sato
,
Takaaki Kishino
,
Masaki Murata
,
Akinari Takao
,
Kazuhiro Mizukami
,
Ken Kinjo
,
Shunji Fujimori
,
Takahiro Uotani
,
MINORU FUJITA
,
Sho Suzuki
,
Toshiaki Narasaka
,
Junnosuke Hayasaka
,
Tomohiro FUNABIKI
,
Yuzuru Kinjo
,
Mizuki Azuma
,
Shu Kiyotoki
,
Tatsuya Mikami
,
Ryosuke Gushima
,
Hiroyuki FUJII
,
Yuta Fuyuno
,
Naohiko Gunji
,
Yosuke Toya
,
Kazuyuki Narimatsu
,
Koji Nagaike
,
Tetsu Kinjo
,
Yorinobu Sumida
,
Sadahiro Funakoshi
,
Kiyonori Kobayashi
,
Tamotsu Matsuhashi
,
Yuga Komaki
,
Kuniko Miki
,
Kazuhiro Watanabe
,
Kazuki Yamamoto
,
Takaaki Yoshimoto
,
Ayaka Takasu
,
Takashi Ikeya
,
Fumio Omata
,
Katsuyuki Fukuda
,
Mitsuru Kaise
,
Naoyoshi Nagata
Publication type: Journal Article
Publication date: 2023-01-01
scimago Q1
wos Q1
SJR: 2.018
CiteScore: 8.1
Impact factor: 7.5
ISSN: 00165107, 10976779
PubMed ID:
35931139
Gastroenterology
Radiology, Nuclear Medicine and imaging
Abstract
We aimed to determine the optimal timing of colonoscopy and factors that benefit patients who undergo early colonoscopy for acute lower GI bleeding.We identified 10,342 patients with acute hematochezia (CODE BLUE-J study) admitted to 49 hospitals in Japan. Of these, 6270 patients who underwent a colonoscopy within 120 hours were included in this study. The inverse probability of treatment weighting method was used to adjust for baseline characteristics among early (≤24 hours, n = 4133), elective (24-48 hours, n = 1137), and late (48-120 hours, n = 1000) colonoscopy. The average treatment effect was evaluated for outcomes. The primary outcome was 30-day rebleeding rate.The early group had a significantly higher rate of stigmata of recent hemorrhage (SRH) identification and a shorter length of stay than the elective and late groups. However, the 30-day rebleeding rate was significantly higher in the early group than in the elective and late groups. Interventional radiology (IVR) or surgery requirement and 30-day mortality did not significantly differ among groups. The interaction with heterogeneity of effects was observed between early and late colonoscopy and shock index (shock index <1, odds ratio [OR], 2.097; shock index ≥1, OR, 1.095; P for interaction = .038) and performance status (0-2, OR, 2.481; ≥3, OR, .458; P for interaction = .022) for 30-day rebleeding. Early colonoscopy had a significantly lower IVR or surgery requirement in the shock index ≥1 cohort (OR, .267; 95% confidence interval, .099-.721) compared with late colonoscopy.Early colonoscopy increased the rate of SRH identification and shortened the length of stay but involved an increased risk of rebleeding and did not improve mortality and IVR or surgery requirement. Early colonoscopy particularly benefited patients with a shock index ≥1 or performance status ≥3 at presentation.
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Shiratori Y. et al. Timing of colonoscopy in acute lower GI bleeding: a multicenter retrospective cohort study // Gastrointestinal Endoscopy. 2023. Vol. 97. No. 1. p. 89-99.e10.
GOST all authors (up to 50)
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Shiratori Y. et al. Timing of colonoscopy in acute lower GI bleeding: a multicenter retrospective cohort study // Gastrointestinal Endoscopy. 2023. Vol. 97. No. 1. p. 89-99.e10.
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TY - JOUR
DO - 10.1016/j.gie.2022.07.025
UR - https://doi.org/10.1016/j.gie.2022.07.025
TI - Timing of colonoscopy in acute lower GI bleeding: a multicenter retrospective cohort study
T2 - Gastrointestinal Endoscopy
AU - Shiratori, Yasutoshi
AU - Ishii, Naoki
AU - Aoki, Tomonori
AU - Kobayashi, Katsumasa
AU - Yamauchi, Atsushi
AU - Yamada, Atsuo
AU - Omori, Jun
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 - Azuma, Mizuki
AU - Kiyotoki, Shu
AU - Mikami, Tatsuya
AU - Gushima, Ryosuke
AU - FUJII, Hiroyuki
AU - Fuyuno, Yuta
AU - Gunji, Naohiko
AU - Toya, Yosuke
AU - Narimatsu, Kazuyuki
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 - Miki, Kuniko
AU - Watanabe, Kazuhiro
AU - Yamamoto, Kazuki
AU - Yoshimoto, Takaaki
AU - Takasu, Ayaka
AU - Ikeya, Takashi
AU - Omata, Fumio
AU - Fukuda, Katsuyuki
AU - Kaise, Mitsuru
AU - Nagata, Naoyoshi
PY - 2023
DA - 2023/01/01
PB - Elsevier
SP - 89-99.e10
IS - 1
VL - 97
PMID - 35931139
SN - 0016-5107
SN - 1097-6779
ER -
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BibTex (up to 50 authors)
Copy
@article{2023_Shiratori,
author = {Yasutoshi Shiratori and Naoki Ishii and Tomonori Aoki and Katsumasa Kobayashi and Atsushi Yamauchi and Atsuo Yamada and Jun Omori 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 Mizuki Azuma and Shu Kiyotoki and Tatsuya Mikami and Ryosuke Gushima and Hiroyuki FUJII and Yuta Fuyuno and Naohiko Gunji and Yosuke Toya and Kazuyuki Narimatsu 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 Kuniko Miki and Kazuhiro Watanabe and Kazuki Yamamoto and Takaaki Yoshimoto and Ayaka Takasu and Takashi Ikeya and Fumio Omata and Katsuyuki Fukuda and others},
title = {Timing of colonoscopy in acute lower GI bleeding: a multicenter retrospective cohort study},
journal = {Gastrointestinal Endoscopy},
year = {2023},
volume = {97},
publisher = {Elsevier},
month = {jan},
url = {https://doi.org/10.1016/j.gie.2022.07.025},
number = {1},
pages = {89--99.e10},
doi = {10.1016/j.gie.2022.07.025}
}
Cite this
MLA
Copy
Shiratori, Yasutoshi, et al. “Timing of colonoscopy in acute lower GI bleeding: a multicenter retrospective cohort study.” Gastrointestinal Endoscopy, vol. 97, no. 1, Jan. 2023, pp. 89-99.e10. https://doi.org/10.1016/j.gie.2022.07.025.