Recurrence and Mortality Among Patients Hospitalized for Acute Lower Gastrointestinal Bleeding

Aoki, Tomonori; Nagata, Naoyoshi; Niikura, Ryota; Shimbo, Takuro; Tanaka, Shohei; Sekine, Katsunori; Kishida, Yoshihiro; Watanabe, Kazuhiro; Sakurai, Toshiyuki; Yokoi, Chizu; Akiyama, Junichi; Yanase, Mikio; Mizokami, Masashi; Uemura, Naomi

doi:10.1016/j.cgh.2014.06.023

Cited by 83 publications

(97 citation statements)

References 31 publications

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“…Prior studies indicated that non-aspirin antiplatelet use were risk factors for LGIB and its recurrence 8,10 , suggesting the initial assessment of non-aspirin antiplatelet agents as well as aspirin might become more important. We also found that no diarrhea and no symptoms of abdominal tenderness were significant predictors for severe bleeding.…”

Section: Discussionmentioning

confidence: 98%

“…Table 3 shows rates of severe bleeding, sensitivity, specificity, and likelihood ratios determined by predictive scores. The rates of severe bleeding with 0, 1, 2, 3, 4, and ≥ 5 predictors were 2.0%, 10.0%, 18.3%, 34.8%, 51.6%, and 75.7%, respectively (P < 0.001 for trend). The AUC of the score was 0.77 (95% CI, 0.73-0.82; Figure 2).…”

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 91%

“…LGIB recurrence after discharge, 10 but the number of patients was too low to identify details of specific clinical predictors for severe bleeding or in-hospital outcomes, particularly comorbidities, medications, presenting symptoms, vital signs, and laboratory data.…”

Section: Introductionmentioning

confidence: 97%

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Development and Validation of a Risk Scoring System for Severe Acute Lower Gastrointestinal Bleeding

Aoki

Nagata

Shimbo

et al. 2016

Clinical Gastroenterology and Hepatology

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111

112

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Section: Discussionmentioning

confidence: 98%

Section: A C C E P T E D Accepted Manuscriptmentioning

confidence: 91%

See 1 more Smart Citation

Development and Validation of a Risk Scoring System for Severe Acute Lower Gastrointestinal Bleeding

Aoki

Nagata

Shimbo

et al. 2016

Clinical Gastroenterology and Hepatology

Self Cite

111

112

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“…The GI tract represents the most common bleeding site, with an age-standardized incidence rate of 5.8 per 1000 person-year [17], i.e., an approximately three-fold increased risk as compared with the general population [18]. The proportions of acute GI bleeders who take VKAs are 8-15% and 7% for upper [19][20][21] and lower GI bleeding, respectively [22]. The spectrum of endoscopic findings in VKA users who present with non-variceal acute upper GI bleeding is similar to that observed in patients taking no anticoagulants, with peptic ulcer being the main cause of bleeding [23].…”

Section: Introductionmentioning

confidence: 99%

Management of anticoagulation in patients with acute gastrointestinal bleeding

Radaelli

Dentali

Repici

et al. 2015

Digestive and Liver Disease

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Acute gastrointestinal bleeding represents the most common adverse event associated with the use of oral anticoagulant therapy. Due to increasing prescription of anticoagulants worldwide, gastroenterologists are more and more called to deal with bleeding patients taking these medications. Their management is challenging because several issues have to be taken into account, such as the severity of bleeding, the intensity of anticoagulation, the patient's thrombotic risk and endoscopy findings. The recent introduction into the marketplace of new direct oral anticoagulants, for whom specific reversal agents are still lacking, further contributes to make the decision-making process even more demanding. Available evidence on this topic is limited and practice guidelines by gastroenterology societies only marginally address key issues for clinicians, including when and how to reverse coagulopathy, the optimal timing of endoscopy and when and how to resume anticoagulation thereafter. The present paper reviews the evidence in the literature and provides practical algorithms to support clinicians in the management of patients on anticoagulants who present with acute gastrointestinal bleeding.

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“…1 Some patients still develop re-bleeding, or it may not be possible to stop hemodynamically significant bleeding by endoscopy. 15,16 In these cases there has been a paradigm shift from surgical treatment to interventional radiology in the last few years. 17 …”

Section: Endoscopic Therapymentioning

confidence: 99%

Endoscopic and angiographic management of lower gastrointestinal bleeding: Review of the published literature

Werner

Manner

Nguyen-Tat

et al. 2017

United European Gastroenterology Journal

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Lower gastrointestinal bleeding is common and occurs often in elderly patients. In rare cases it is associated with hemorrhagic shock. A large number of such bleedings, which are often caused by colon diverticula, subside spontaneously. Alternatively they can be treated by endoscopic procedures successfully. Given the aging population of our society, the rising incidence of lower gastrointestinal tract bleeding and new anticoagulant therapies, some of the bleedings tend to be severe. Colonoscopy is the established standard procedure for the diagnosis and treatment of lower gastrointestinal bleeding. However, a small number of patients experience re-bleeding or shock; their bleeding does not resolve spontaneously and cannot be treated successfully by endoscopic procedures. In such patients, interventional radiology is very useful for the detection of bleeding and the achievement of hemostasis. Against this background we performed a literature search using PubMed to identify all relevant studies focused on the endoscopic and radiological management of lower gastrointestinal bleeding and present recent conclusions on the subject.

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Recurrence and Mortality Among Patients Hospitalized for Acute Lower Gastrointestinal Bleeding

Cited by 83 publications

References 31 publications

Development and Validation of a Risk Scoring System for Severe Acute Lower Gastrointestinal Bleeding

Development and Validation of a Risk Scoring System for Severe Acute Lower Gastrointestinal Bleeding

Management of anticoagulation in patients with acute gastrointestinal bleeding

Endoscopic and angiographic management of lower gastrointestinal bleeding: Review of the published literature

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