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Early colonoscopy in patients with acute diverticular bleeding is associated with improvement in healthcare-resource utilization 被引量:1
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作者 Hamzeh Saraireh obada tayyem +2 位作者 Mohamed Tausif Siddiqui Bashar Hmoud Mohammad Bilal 《Gastroenterology Report》 SCIE EI 2019年第2期115-120,I0002,共7页
Background:Diverticular bleeding(DB)is the most common cause of severe acute lower gastrointestinal bleeding(GIB)in developed countries.The role of early colonoscopy(<24 hours)continues to remain controversial and ... Background:Diverticular bleeding(DB)is the most common cause of severe acute lower gastrointestinal bleeding(GIB)in developed countries.The role of early colonoscopy(<24 hours)continues to remain controversial and data on early colonoscopy in acute DB are scant.We aimed to evaluate the effect of timing of colonoscopy on outcomes in patients with acute DB using a nationwide inpatient sample.Methods:Data from the nationwide inpatient sample from 2012 to 2014 were used.The ninth version of the International Classification of Diseases coding system ICD 9 was used for patient selection.We included discharges with the primary and secondary inpatient diagnosis of diverticulosis with bleeding and diverticulitis with bleeding.Discharges with no primary or secondary diagnosis of diverticulosis with bleeding,diverticulitis with bleeding,patients who were less than 18 years old and those who did not undergo colonoscopy during the admission were excluded.The primary outcomes were length of stay(LOS)and total hospitalization costs.Results:A total of 88600 patients were included in our analysis,amongstwhom 45020(50.8%)had colonoscopy within 24hours of admission(early colonoscopy),while 43580(49.2%)patients had colonoscopy after 24hours of admission(late colonoscopy).LOS was significantly lower in patients with early colonoscopy as compared to those with late colonoscopy(3.7 vs 5.6days,P<0.0001).Total hospitalization costs were also significantly lower in patients with early colonoscopy($9317 vs$11767,P<0.0001).There was no difference inmortality between both groups(0.7 vs 0.8%).After adjusting for potential confounders,the differences in LOS and total hospitalization costs between early and late colonoscopy remained statistically significant.Conclusions:Early colonoscopy in acute DB significantly reduced LOS and total hospitalization costs.There was no significant difference inmortality observed.Performance of early colonoscopy in the appropriate patients presenting with acute DB can have potential cost-saving implications.Further research is needed to identify which patients would benefit from early colonoscopy in DB. 展开更多
关键词 Diverticular bleeding COLONOSCOPY lower gastrointestinal bleeding timing of colonoscopy
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