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• W2009145110 abstract "Introduction: Lower gastrointestinal bleeding (LGB) is a common and potentially life-threatening disorder that often requires hospitalization. Colonoscopy is considered as the diagnostic procedure of choice in LGB but the best moment to perform it remains controversial. Aims & Methods: To determine whether delay in performing colonoscopy to patients with LGB influences diagnostic accuracy, the chance of offering endoscopic therapy, and the hospital stay. Design: prospective cohort study. Setting: tertiary teaching hospital. Patients: all consecutive patients admitted from January 2005 and May 2006. Analysis: The effect of colonoscopy delay on diagnostic accuracy, the chance of offering endoscopic therapy and the hospital stay were assessed by univariate and multivariate analysis adjusting for age, comorbidity, and severity of the bleeding episode. Results: A total of 212 patients with LGB were admitted during the period of study. Colonoscopy was performed to 84.4% (180/212) of patients and some kind of endoscopic therapy was given to the 18% (32/180) of them. A definitive source of bleeding was found in 56.7% (102/180) and a presumptive cause in 33.9% (61/180). Diverticular bleeding was the most common cause of LGB (25%, 45/180). Other causes were ischemic colitis in 17.2% (31/180) of patients, colonic neoplasm in 14.4% (26/180), haemorrhoids or fissures in 13.9% (25/180), angiodysplasia in 6.1% (11/180), other diagnoses in 14% (20/180). The cause remained unknown in 9.4% of patients (17/140). Colonoscopy was performed during the first 24 hours after admission in 51.1% of patients (92/180), between 24 and 48 hours in 20% (36/180), between 48 and 72 hours in 20% (36/180) and later than 72 hours in 8.8% (16/180). A definite source of bleeding was identified in 67% (62/92) of patients when colonoscopy was performed within the first of 24 hours but in only 45% (40/88) if it was performed later (p < 0.01). Colonoscopy within the first 24 hours was associated to early discharge (3.3 ± 3.5 days vs. 5.9 ± 4.7 days; p < 0.001) and with a better chance to receive endoscopic therapy (23% (21/92) vs. 12% (11/88), p = 0.07). In the multivariate analysis achieving a colonoscopy during the first 24 hours was independently associated with a better chance of identifying a definitive source of bleeding and receive endoscopic therapy, and with shorter hospital stay (hazard ratio 0.42; 95% CI, 0.21-0.81; p = 0.004; hazard ratio 0.38; 95% CI, 0.16-0.91; p = 0.03 and hazard ratio 0.69; 95% CI, 0.59-0.79; p < 0.001, respectively). Conclusion: Early colonoscopy can improve the management of the LGB with regard to its greater diagnostic accuracy and reduction of hospital stay." @default.
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• W2009145110 date "2007-04-01" @default.
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• W2009145110 title "Colonoscopy Delay in Lower Gastrointestinal Bleeding: Influence On Diagnostic Accuracy, Endoscopic Therapy and Hospital Stay" @default.
• W2009145110 doi "https://doi.org/10.1016/j.gie.2007.03.614" @default.
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