Timing of colonoscopy in acute lower GI bleeding: a multicenter retrospective cohort study

• DOI: 10.1016/j.gie.2022.07.025
• Publication Date: 2022-08-02T15:23:52Z
• Authors: Yasutoshi Shiratori; Naoki Ishii; Tomonori Aoki; Katsumasa Kobayashi; Atsushi Yamauchi; Atsuo Yamada; Jun Omori; Taiki Aoyama; Naoyuki Tominaga; Yoshinori Sato; Takaaki Kishino; Tsunaki Sawada; Masaki Murata; Akinari Takao; Kazuhiro Mizukami; Ken Kinjo; Shunji Fujimori; Takahiro Uotani; Minoru Fujita; Hiroki Sato; Sho Suzuki; Toshiaki Narasaka; Junnosuke Hayasaka; Tomohiro Funabiki; Yuzuru Kinjo; Akira Mizuki; Shu Kiyotoki; Tatsuya Mikami; Ryosuke Gushima; Hiroyuki Fujii; Yuta Fuyuno; Naohiko Gunji; Yosuke Toya; Kazuyuki Narimatsu; Noriaki Manabe; 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
• Keywords: Hematochezia

Background and AimsWe aimed to determine the optimal timing of colonoscopy factors that benefit patients who undergo early for acute lower GI bleeding.MethodsWe identified 10,342 with hematochezia (CODE BLUE-J study) admitted 49 hospitals in Japan. Of these, 6270 underwent a within 120 hours were included this study. The inverse probability treatment weighting method was used adjust baseline characteristics among (≤24 hours, n = 4133), elective (24-48 1137), late (48-120 1000) colonoscopy. average effect evaluated outcomes. primary outcome 30-day rebleeding rate.ResultsThe group had significantly higher rate stigmata recent hemorrhage (SRH) identification shorter length stay than groups. However, Interventional radiology (IVR) or surgery requirement mortality did not differ interaction heterogeneity effects observed between shock index (shock <1, odds ratio [OR], 2.097; ≥1, OR, 1.095; P .038) performance status (0-2, 2.481; ≥3, .458; .022) rebleeding. Early IVR ≥1 cohort (OR, .267; 95% confidence interval, .099-.721) compared colonoscopy.ConclusionsEarly increased SRH shortened but involved an risk improve requirement. particularly benefited ≥3 at presentation. We bleeding. rate.