Lower gastrointestinal bleeding in the elderly

Chait, Maxwell M

doi:10.4253/wjge.v2.i5.147

Cited by 59 publications

(60 citation statements)

References 57 publications

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“…Acute, overt lower gastrointestinal bleeding (LGIB), manifested as hematochezia, often leads to hospital admission [1–5]. Common causes of acute LGIB include colonic diverticulosis, vascular ectasias, ischemic colitis, colorectal polyps and neoplasms, inflammatory bowel disease, anorectal conditions, and postpolypectomy bleeding [2, 4–5].…”

Section: Introductionmentioning

confidence: 99%

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Endoscopic hemostasis is rarely used for hematochezia: a population-based study from the Clinical Outcomes Research Initiative National Endoscopic Database

Fisher

Gralnek

Eisen

et al. 2014

Gastrointestinal Endoscopy

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Background Data on use of endoscopic hemostasis performed during colonoscopy for hematochezia are primarily derived from expert opinion and case series from tertiary care settings. Objective To characterize patients with hematochezia who underwent in-patient colonoscopy and compare those who received endoscopic hemostasis with those who did not receive endoscopic hemostasis. Design Retrospective analysis Setting Clinical Outcomes Research Initiative (CORI) National Endoscopic Database 2002 – 2008 Patients Adults with hematochezia Interventions None Main Outcome Measurements Demographics, co-morbidity, practice setting, adverse events, and colonoscopy procedural characteristics and findings. Results We identified 3,151 persons who underwent in-patient colonoscopy for hematochezia. Endoscopic hemostasis was performed in 144 patients (4.6%). Of those who received endoscopic hemostasis, the majority were male (60.3%), White (83.3%), older (mean age 70.9 ± 12.3 years), had a low risk ASA Score (53.9%), and underwent colonoscopy in a community setting (67.4%). The hemostasis-receiving cohort was significantly more likely to be White (83.3% vs. 71.0%, p=0.02), have more co-morbidities (ASA Score III and IV 46.2% vs. 36.0%, p=0.04), and have the cecum reached (95.8% vs. 87.7%, p=0.003). Those receiving hemostasis were significantly more likely to have an endoscopic diagnosis of AVM’s (32.6% vs. 2.6%) p=0.0001or solitary ulcer (8.3% vs. 2.1%), p<0.0001. Limitations Retrospective database analysis. Conclusions Less than five percent of persons presenting with hematochezia and undergoing inpatient colonoscopy received endoscopic hemostasis. These findings differ from published tertiary care setting data. These data provide new insights on in-patient colonoscopy performed primarily in a community practice setting for patients with hematochezia.

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Section: Introductionmentioning

confidence: 99%

“…Common causes of acute LGIB include colonic diverticulosis, vascular ectasias, ischemic colitis, colorectal polyps and neoplasms, inflammatory bowel disease, anorectal conditions, and postpolypectomy bleeding [2, 4–5]. …”

Section: Introductionmentioning

confidence: 99%

Endoscopic hemostasis is rarely used for hematochezia: a population-based study from the Clinical Outcomes Research Initiative National Endoscopic Database

Fisher

Gralnek

Eisen

et al. 2014

Gastrointestinal Endoscopy

View full text Add to dashboard Cite

show abstract

“…[2][3][4] Although rebleeding is known to occur after initial management of LGIB, [5][6][7] its natural history remains unclear. The in-hospital mortality rate of LGIB patients is less than 5%, 2,4,5 but the long-term mortality rate is unknown.…”

mentioning

confidence: 99%