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• W2914654013 abstract "Introduction: Diagnostic yield of computed tomography angiogram (CTA) for lower gastrointestinal (GI) bleeding is low. CTA does put patients at risk for contrast related injury and radiation exposure. Methods: Our retrospective study involved chart review of adult patients who underwent CTA for presumptive diagnosis of acute active lower gastrointestinal bleeding. The study cohort was divided into two groups based on presence [CTA (+)] or absence [CTA (-)] of active bleed on CTA. Interventional radiology angiogram (IRA) was followed for subjects with CTA (+). We collected data regarding- hypotension, tachycardia, elevated INR (>1.5), thrombocytopenia (<150,000), need of blood transfusion, antiplatelet or anticoagulant medication use for each patient. CTA (+) and CTA (-) groups were further divided into subgroups based on use of anticoagulants or presence of high INR (1.5). We then calculated the interval from the time the CTA was ordered for each patient to the time of its completion for each group and subgroup. Chi-square test and unpaired t-test was used to calculate statistical significance (P<0.05). Results: 200 adult patients underwent CTA for presumed active lower GI bleeding. 24% (48/200) had a positive CTA and rest 76% (152/200) had negative CTA. CTA (+) group had higher number of patients with INR>1.5 (27.1%) compared to CTA (-) group (20.8%)( P=0.045). Similarly, CTA (+) group had higher number of patients on anticoagulants (27.1%) compared to CTA (-) group (14.5%)(P=0.045). No statistical significant difference (P>0.05) was noted for number of patients with hypotension, tachycardia, thrombocytopenia, need of blood transfusion or use of antiplatelet medication across the CTA (+) and CTA (-) group. Average time (order to completion) for CTA (+) group was 135 min (range, 34- 627 min) compared to 204 min for CTA negative group (range, 11- 1293 min)( P=0.006). After excluding patients with high INR/anticoagulant use, average time (order to completion) for CTA (+) group was 147 min compared to 177 min for CTA (-) group (P=0.33). For patients on anticoagulants or high INR group, average time (order to completion) for CTA (+) group was 116 min compared to 273 min for CTA (-) group (P=0.0012). Conclusion: Average time (order to completion of CTA) was significantly shorter for CTA (+) group compared to CTA (-) group (P=0.006). Similar trend was seen for patients on anticoagulants or with high INR (>1.5) across CTA (+) and CTA (-) group (P=0.0012)." @default.
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• W2914654013 date "2017-10-01" @default.
• W2914654013 modified "2023-09-26" @default.
• W2914654013 title "Is Time the Real Key to Improve Diagnostic Yield of CT Angiogram for Lower GI Bleeding?" @default.
• W2914654013 doi "https://doi.org/10.14309/00000434-201710001-00572" @default.
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