Patient characteristics, causes, interventions and outcomes in Lower gastrointestinal bleeding patient at Chonburi Hospital
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Abstract
BACKGROUND: Lower gastrointestinal bleeding (LGIB) is common reason for admission. The annual incidence rate of LGIB is around 20 cases/100,000 population, with an increased risk especially in the elderly. Interestingly, there is paucity about patient characteristics, causes, interventions and outcomes in Thailand. Knowing about these data is useful in care patient.
OBJECTIVES: This study aimed to identify patient characteristics, causes, interventions, and outcomes in adult patients who were admitted to Chonburi hospital with LGIB.
METHODS: This is descriptive study. We retrospectively reviewed medical records based on ICD 9 and ICD 10, Endoscopic unit record and at ER registration for patients age ≥ 16 years admitted with diagnose LGIB or diagnose associated with LGIB at Chonburi hospital (tertiary care hospital) during 1 October 2017- 30 September 2021. Patients diagnosed with UGIB with or without endoscopic hemostasis during EGD were excluded.
RESULTS: A total 221 patients were recruited. Most were female (53.4%), mean age 65.4 years. Most patients had comorbidity. Most common comorbidity were hypertension, diabetes and chronic kidney disease. 40% of them got antiplatelet, aspirin was the most common. Around ¼ had previous LGIB admission. Shock was found 6%. Most 3 common diagnoses were hemorrhoid (32.6%), diverticular disease (31.7%) and unexplained bleeding (23.1%). Most common investigation was colonoscopy (70.1%) and median time to colonoscopy 48 hours. Most common intervention were RBC transfusion (73.3%), endoscopic hemostasis (5.9%), surgery (2.7%) and embolization (1.4%). Median length of stay was 5 days, 10.4% were re-bleeding, 8.6% were continuous bleeding and 10.9% were readmitted with LGIB within 28 days. All causes mortality was 5.4%.
CONCLUSIONS: Most LGIB patient were elderly, multiple comorbidity, on antiplatelet drug and severe. Most patients were colonoscopy and RBC transfusion. Outcomes were not very good.
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References
Feldman M, Friedman LS, Brandt LJ. Sleisenger and Fordtran’s Gastrointestinal and liver disease. 10th ed. United States of America: ELSEVIER SAUNDERS; 2016.
Podolsky DK, Camilleri M, Fitz JG, Kalloo AN, Shanahan F, Wang TC. YAMADA’S Textbook of gastroenterology. 6th ed. Malaysia: John Wiley & Sons Ltd; 2016.
Longstreth G. Epidemiology and Outcome of Patients Hospitalized with Acute Lower Gastrointestinal Hemorrhage: A Population-Based Study. Am J Gastroenterol. 1997; 92:419-24.
Oakland K, Guy R, Uberoi R, Hogg R, Mortensen N, Murphy MF, et al. Acute lower GI bleeding in the UK: patient characteristics, interventions and outcomes in the first nationwide audit. Gut. 2018; 67:654–62
Bai Y, Peng J, Gao J, Zou DW, Li ZS. Epidemiology of lower gastrointestinal bleeding in China: single-center series and systematic analysis of Chinese literature with 53,951 patients. J Gastroenterol Hepatol. 2011; 26: 678-82.