Nationwide large-scale data of acute lower gastrointestinal bleeding in Japan uncover detailed etiologies and relevant outcomes: CODE BLUE J-Study Article Swipe
Naoyoshi Nagata
,
Katsumasa Kobayashi
,
Atsushi Yamauchi
,
Atsuo Yamada
,
Jun Omori
,
Takashi Ikeya
,
Taiki Aoyama
,
Naoyuki Tominaga
,
Yoshinori Sato
,
Takaaki Kishino
,
Naoki Ishii
,
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
,
Kana Kawagishi
,
Tamotsu Matsuhashi
,
Yuga Komaki
,
Kuniko Miki
,
Kazuhiro Watanabe
,
Masakatsu Fukuzawa
,
Takao Itoi
,
Naomi Uemura
,
Takashi Kawai
,
Mitsuru Kaise
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1101/2021.01.18.21250035
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1101/2021.01.18.21250035
Background The value of endoscopy for acute lower GI bleeding (ALGIB) remains unclear, given few large cohort studies. We aim to provide detailed clinical data for ALGIB management and to identify patients at risk for adverse outcomes based on endoscopic diagnosis. Methods We conducted a multicenter, retrospective cohort study, named CODE BLUE J-Study, in 49 hospitals throughout Japan and studied 10,342 cases admitted for outpatient-onset of acute hematochezia. Results Cases were mostly elderly, with 29.5% hemodynamic instability and 60.1% comorbidity. 69.1% and 87.7 % of cases underwent CT and colonoscopy, respectively. Diagnostic yield of colonoscopy reached 94.9%, revealing 48 etiologies, most frequently diverticular bleeding. During hospitalization, the endoscopic therapy rate was 32.7%, mostly using clipping and band ligation. IVR and surgery were infrequently performed, for 2.1% and 1.4%. In-hospital rebleeding and death occurred in 15.2% and 0.9%. Diverticular bleeding cases had higher rates of hemodynamic instability, rebleeding, endoscopic therapy, IVR, and transfusion, but lower rates of death and surgery than other etiologies. Small bowel bleeding cases had significantly higher rates of surgery, IVR, and transfusion than other etiologies. Malignancy or upper GIB cases had significantly higher rates of thromboembolism and death than other etiologies. Etiologies that have favorable outcomes were ischemic colitis, infectious colitis, and post-endoscopy bleeding. Conclusions Large-scale data of patients with acute hematochezia revealed high proportions of colonoscopy and CT, resulting in high endoscopic therapy rates. We highlight the importance of colonoscopy in detecting accurate bleeding etiologies that stratify patients at high or low risk of adverse outcomes.
Related Topics
Concepts
Medicine
Hematochezia
Colonoscopy
Etiology
Mortality rate
Internal medicine
Surgery
Ischemic colitis
Retrospective cohort study
Colorectal cancer
Colitis
Cancer
Metadata
- Type
- preprint
- Language
- en
- Landing Page
- https://doi.org/10.1101/2021.01.18.21250035
- https://www.medrxiv.org/content/medrxiv/early/2021/01/20/2021.01.18.21250035.full.pdf
- OA Status
- green
- Cited By
- 14
- References
- 28
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3122784001
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3122784001Canonical identifier for this work in OpenAlex
- DOI
-
https://doi.org/10.1101/2021.01.18.21250035Digital Object Identifier
- Title
-
Nationwide large-scale data of acute lower gastrointestinal bleeding in Japan uncover detailed etiologies and relevant outcomes: CODE BLUE J-StudyWork title
- Type
-
preprintOpenAlex work type
- Language
-
enPrimary language
- Publication year
-
2021Year of publication
- Publication date
-
2021-01-20Full publication date if available
- Authors
-
Naoyoshi Nagata, Katsumasa Kobayashi, Atsushi Yamauchi, Atsuo Yamada, Jun Omori, Takashi Ikeya, Taiki Aoyama, Naoyuki Tominaga, Yoshinori Sato, Takaaki Kishino, Naoki Ishii, 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, Kana Kawagishi, Tamotsu Matsuhashi, Yuga Komaki, Kuniko Miki, Kazuhiro Watanabe, Masakatsu Fukuzawa, Takao Itoi, Naomi Uemura, Takashi Kawai, Mitsuru KaiseList of authors in order
- Landing page
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https://doi.org/10.1101/2021.01.18.21250035Publisher landing page
- PDF URL
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https://www.medrxiv.org/content/medrxiv/early/2021/01/20/2021.01.18.21250035.full.pdfDirect link to full text PDF
- Open access
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YesWhether a free full text is available
- OA status
-
greenOpen access status per OpenAlex
- OA URL
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https://www.medrxiv.org/content/medrxiv/early/2021/01/20/2021.01.18.21250035.full.pdfDirect OA link when available
- Concepts
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Medicine, Hematochezia, Colonoscopy, Etiology, Mortality rate, Internal medicine, Surgery, Ischemic colitis, Retrospective cohort study, Colorectal cancer, Colitis, CancerTop concepts (fields/topics) attached by OpenAlex
- Cited by
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14Total citation count in OpenAlex
- Citations by year (recent)
-
2024: 3, 2023: 7, 2022: 2, 2021: 2Per-year citation counts (last 5 years)
- References (count)
-
28Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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