J Korean Med Sci.  2016 Oct;31(10):1611-1616. 10.3346/jkms.2016.31.10.1611.

The Clinical Outcomes of Lower Gastrointestinal Bleeding Are Not Better than Those of Upper Gastrointestinal Bleeding

• Kwak MS
• Cha JM
• Han YJ
• Yoon JY
• Jeon JW
• Shin HP
• Joo KR
• Lee JI

• KMID: 2468252
• DOI: http://doi.org/10.3346/jkms.2016.31.10.1611

Abstract

The incidence of lower gastrointestinal bleeding (LGIB) is increasing; however, predictors of outcomes for patients with LGIB are not as well defined as those for patients with upper gastrointestinal bleeding (UGIB). The aim of this study was to identify the clinical outcomes and the predictors of poor outcomes for patients with LGIB, compared to outcomes for patients with UGIB. We identified patients with LGIB or UGIB who underwent endoscopic procedures between July 2006 and February 2013. Propensity score matching was used to improve comparability between LGIB and UGIB groups. The clinical outcomes and predictors of 30-day rebleeding and mortality rate were analyzed between the two groups. In total, 601 patients with UGIB (n = 500) or LGIB (n = 101) were included in the study, and 202 patients with UGIB and 101 patients with LGIB were analyzed after 2:1 propensity score matching. The 30-day rebleeding and mortality rates were 9.9% and 4.5% for the UGIB group, and 16.8% and 5.0% for LGIB group, respectively. After logistic regression analysis, the Rockall score (P = 0.013) and C-reactive protein (CRP; P = 0.047) levels were significant predictors of 30-day mortality in patients with LGIB; however, we could not identify any predictors of rebleeding in patients with LGIB. The clinical outcomes for patients with LGIB are not better than clinical outcomes for patients with UGIB. The clinical Rockall score and serum CRP levels may be used to predict 30-day mortality in patients with LGIB.

Keyword

Gastrointestinal Bleeding; Colonoscopy; Hematochezia; Mortality; Prognosis

MeSH Terms

Adult
Aged
C-Reactive Protein/analysis
Endoscopy, Digestive System
Female
Gastrointestinal Hemorrhage/mortality/*pathology
Humans
Length of Stay
Male
Middle Aged
Odds Ratio
Propensity Score
Retrospective Studies
Risk Factors
Survival Rate
C-Reactive Protein