Loading…

Urgent colonoscopy in patients with lower GI bleeding: a systematic review and meta-analysis

Background and Aims Lower GI bleeding (LGIB) is a common cause of morbidity and mortality. Colonoscopy is indicated in all hospitalized patients with LGIB, yet the time frame for performing colonoscopy remains unclear. Prior studies of outcomes in urgent versus elective colonoscopy have yielded conf...

Full description

Saved in:
Bibliographic Details
Published in:Gastrointestinal endoscopy 2017-07, Vol.86 (1), p.107-117.e1
Main Authors: Kouanda, Abdul M., MD, Somsouk, Ma, MD, Sewell, Justin L., MD, MPH, Day, Lukejohn W., MD
Format: Article
Language:English
Subjects:
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
cited_by cdi_FETCH-LOGICAL-c408t-df905d99c98cbad6a68ac9c49d85f55ef8ad9ff8490b8e608a7bc2dcce2b7f3b3
cites cdi_FETCH-LOGICAL-c408t-df905d99c98cbad6a68ac9c49d85f55ef8ad9ff8490b8e608a7bc2dcce2b7f3b3
container_end_page 117.e1
container_issue 1
container_start_page 107
container_title Gastrointestinal endoscopy
container_volume 86
creator Kouanda, Abdul M., MD
Somsouk, Ma, MD
Sewell, Justin L., MD, MPH
Day, Lukejohn W., MD
description Background and Aims Lower GI bleeding (LGIB) is a common cause of morbidity and mortality. Colonoscopy is indicated in all hospitalized patients with LGIB, yet the time frame for performing colonoscopy remains unclear. Prior studies of outcomes in urgent versus elective colonoscopy have yielded conflicting results and were often underpowered. Our study objective was to compare several outcomes between urgent and elective colonoscopy in patients hospitalized for LGIB. Methods Systematic review and meta-analysis were performed on studies that compared urgent and elective colonoscopy in patients with LGIB. Pooled rates were calculated for specific outcomes, and rate ratios were determined for selected comparison groups. Results Twelve studies met inclusion criteria, with a total sample size of 10,172 patients in the urgent colonoscopy arm and 14,224 patients in the elective colonoscopy arm. Urgent colonoscopy was associated with increased use of endoscopic therapeutic intervention (RR, 1.70; 95% CI, 1.08-2.67). There were no significant differences in bleeding source localization (RR, 1.08; 95% CI, .92-1.25), adverse event rates (RR, 1.05; 95% CI, .65-1.71), rebleeding rates (RR, 1.14; 95% CI, .74-1.78), transfusion requirement (RR, 1.02; 95% CI, .73-1.41), or mortality (RR, 1.17; 95% CI, .45-3.02). Conclusions Urgent colonoscopy appears to be safe and well tolerated, but there is no clear evidence that it alters important clinical outcomes.
doi_str_mv 10.1016/j.gie.2017.01.035
format article
fullrecord <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1866293633</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S0016510717300792</els_id><sourcerecordid>1866293633</sourcerecordid><originalsourceid>FETCH-LOGICAL-c408t-df905d99c98cbad6a68ac9c49d85f55ef8ad9ff8490b8e608a7bc2dcce2b7f3b3</originalsourceid><addsrcrecordid>eNp9kcGKFDEQhoMo7uzqA3iRHL10W0mmO4mCsCy6Lix40D1KSCfVY8buzpj0OPTb-Cw-2WaY1YMHTwXF9_9QXxHygkHNgLWvt_UmYM2ByRpYDaJ5RFYMtKxaKfVjsoICVQ0DeUbOc94CgOKCPSVnXDG5ZlysyNe7tMFppi4OcYrZxd1Cw0R3dg5lnekhzN_oEA-Y6PUN7QZEH6bNG2p__8pLnnEsoKMJfwY8UDt5OuJsKzvZYckhPyNPejtkfP4wL8jdh_dfrj5Wt5-ub64ubyu3BjVXvtfQeK2dVq6zvrWtsk67tfaq6ZsGe2W97nu11tApbEFZ2TnunUPeyV504oK8OvXuUvyxxzybMWSHw2AnjPtsmGpbrkUrREHZCXUp5pywN7sURpsWw8AcrZqtKVbN0aoBZorVknn5UL_vRvR_E380FuDtCcByZFGRTHbFnyuyErrZ-Bj-W__un7QbwhScHb7jgnkb96n4LFeYzA2Yz8e3Hr_KpACQmot7SqufYQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1866293633</pqid></control><display><type>article</type><title>Urgent colonoscopy in patients with lower GI bleeding: a systematic review and meta-analysis</title><source>ScienceDirect Freedom Collection</source><creator>Kouanda, Abdul M., MD ; Somsouk, Ma, MD ; Sewell, Justin L., MD, MPH ; Day, Lukejohn W., MD</creator><creatorcontrib>Kouanda, Abdul M., MD ; Somsouk, Ma, MD ; Sewell, Justin L., MD, MPH ; Day, Lukejohn W., MD</creatorcontrib><description>Background and Aims Lower GI bleeding (LGIB) is a common cause of morbidity and mortality. Colonoscopy is indicated in all hospitalized patients with LGIB, yet the time frame for performing colonoscopy remains unclear. Prior studies of outcomes in urgent versus elective colonoscopy have yielded conflicting results and were often underpowered. Our study objective was to compare several outcomes between urgent and elective colonoscopy in patients hospitalized for LGIB. Methods Systematic review and meta-analysis were performed on studies that compared urgent and elective colonoscopy in patients with LGIB. Pooled rates were calculated for specific outcomes, and rate ratios were determined for selected comparison groups. Results Twelve studies met inclusion criteria, with a total sample size of 10,172 patients in the urgent colonoscopy arm and 14,224 patients in the elective colonoscopy arm. Urgent colonoscopy was associated with increased use of endoscopic therapeutic intervention (RR, 1.70; 95% CI, 1.08-2.67). There were no significant differences in bleeding source localization (RR, 1.08; 95% CI, .92-1.25), adverse event rates (RR, 1.05; 95% CI, .65-1.71), rebleeding rates (RR, 1.14; 95% CI, .74-1.78), transfusion requirement (RR, 1.02; 95% CI, .73-1.41), or mortality (RR, 1.17; 95% CI, .45-3.02). Conclusions Urgent colonoscopy appears to be safe and well tolerated, but there is no clear evidence that it alters important clinical outcomes.</description><identifier>ISSN: 0016-5107</identifier><identifier>EISSN: 1097-6779</identifier><identifier>DOI: 10.1016/j.gie.2017.01.035</identifier><identifier>PMID: 28174123</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Blood Transfusion ; Colonoscopy - adverse effects ; Elective Surgical Procedures ; Emergencies ; Gastroenterology and Hepatology ; Gastrointestinal Hemorrhage - diagnostic imaging ; Gastrointestinal Hemorrhage - mortality ; Gastrointestinal Hemorrhage - therapy ; Humans ; Length of Stay - economics ; Recurrence</subject><ispartof>Gastrointestinal endoscopy, 2017-07, Vol.86 (1), p.107-117.e1</ispartof><rights>American Society for Gastrointestinal Endoscopy</rights><rights>2017 American Society for Gastrointestinal Endoscopy</rights><rights>Copyright © 2017 American Society for Gastrointestinal Endoscopy. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c408t-df905d99c98cbad6a68ac9c49d85f55ef8ad9ff8490b8e608a7bc2dcce2b7f3b3</citedby><cites>FETCH-LOGICAL-c408t-df905d99c98cbad6a68ac9c49d85f55ef8ad9ff8490b8e608a7bc2dcce2b7f3b3</cites><orcidid>0000-0002-7332-1898</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28174123$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Kouanda, Abdul M., MD</creatorcontrib><creatorcontrib>Somsouk, Ma, MD</creatorcontrib><creatorcontrib>Sewell, Justin L., MD, MPH</creatorcontrib><creatorcontrib>Day, Lukejohn W., MD</creatorcontrib><title>Urgent colonoscopy in patients with lower GI bleeding: a systematic review and meta-analysis</title><title>Gastrointestinal endoscopy</title><addtitle>Gastrointest Endosc</addtitle><description>Background and Aims Lower GI bleeding (LGIB) is a common cause of morbidity and mortality. Colonoscopy is indicated in all hospitalized patients with LGIB, yet the time frame for performing colonoscopy remains unclear. Prior studies of outcomes in urgent versus elective colonoscopy have yielded conflicting results and were often underpowered. Our study objective was to compare several outcomes between urgent and elective colonoscopy in patients hospitalized for LGIB. Methods Systematic review and meta-analysis were performed on studies that compared urgent and elective colonoscopy in patients with LGIB. Pooled rates were calculated for specific outcomes, and rate ratios were determined for selected comparison groups. Results Twelve studies met inclusion criteria, with a total sample size of 10,172 patients in the urgent colonoscopy arm and 14,224 patients in the elective colonoscopy arm. Urgent colonoscopy was associated with increased use of endoscopic therapeutic intervention (RR, 1.70; 95% CI, 1.08-2.67). There were no significant differences in bleeding source localization (RR, 1.08; 95% CI, .92-1.25), adverse event rates (RR, 1.05; 95% CI, .65-1.71), rebleeding rates (RR, 1.14; 95% CI, .74-1.78), transfusion requirement (RR, 1.02; 95% CI, .73-1.41), or mortality (RR, 1.17; 95% CI, .45-3.02). Conclusions Urgent colonoscopy appears to be safe and well tolerated, but there is no clear evidence that it alters important clinical outcomes.</description><subject>Blood Transfusion</subject><subject>Colonoscopy - adverse effects</subject><subject>Elective Surgical Procedures</subject><subject>Emergencies</subject><subject>Gastroenterology and Hepatology</subject><subject>Gastrointestinal Hemorrhage - diagnostic imaging</subject><subject>Gastrointestinal Hemorrhage - mortality</subject><subject>Gastrointestinal Hemorrhage - therapy</subject><subject>Humans</subject><subject>Length of Stay - economics</subject><subject>Recurrence</subject><issn>0016-5107</issn><issn>1097-6779</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><recordid>eNp9kcGKFDEQhoMo7uzqA3iRHL10W0mmO4mCsCy6Lix40D1KSCfVY8buzpj0OPTb-Cw-2WaY1YMHTwXF9_9QXxHygkHNgLWvt_UmYM2ByRpYDaJ5RFYMtKxaKfVjsoICVQ0DeUbOc94CgOKCPSVnXDG5ZlysyNe7tMFppi4OcYrZxd1Cw0R3dg5lnekhzN_oEA-Y6PUN7QZEH6bNG2p__8pLnnEsoKMJfwY8UDt5OuJsKzvZYckhPyNPejtkfP4wL8jdh_dfrj5Wt5-ub64ubyu3BjVXvtfQeK2dVq6zvrWtsk67tfaq6ZsGe2W97nu11tApbEFZ2TnunUPeyV504oK8OvXuUvyxxzybMWSHw2AnjPtsmGpbrkUrREHZCXUp5pywN7sURpsWw8AcrZqtKVbN0aoBZorVknn5UL_vRvR_E380FuDtCcByZFGRTHbFnyuyErrZ-Bj-W__un7QbwhScHb7jgnkb96n4LFeYzA2Yz8e3Hr_KpACQmot7SqufYQ</recordid><startdate>20170701</startdate><enddate>20170701</enddate><creator>Kouanda, Abdul M., MD</creator><creator>Somsouk, Ma, MD</creator><creator>Sewell, Justin L., MD, MPH</creator><creator>Day, Lukejohn W., MD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0002-7332-1898</orcidid></search><sort><creationdate>20170701</creationdate><title>Urgent colonoscopy in patients with lower GI bleeding: a systematic review and meta-analysis</title><author>Kouanda, Abdul M., MD ; Somsouk, Ma, MD ; Sewell, Justin L., MD, MPH ; Day, Lukejohn W., MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c408t-df905d99c98cbad6a68ac9c49d85f55ef8ad9ff8490b8e608a7bc2dcce2b7f3b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Blood Transfusion</topic><topic>Colonoscopy - adverse effects</topic><topic>Elective Surgical Procedures</topic><topic>Emergencies</topic><topic>Gastroenterology and Hepatology</topic><topic>Gastrointestinal Hemorrhage - diagnostic imaging</topic><topic>Gastrointestinal Hemorrhage - mortality</topic><topic>Gastrointestinal Hemorrhage - therapy</topic><topic>Humans</topic><topic>Length of Stay - economics</topic><topic>Recurrence</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kouanda, Abdul M., MD</creatorcontrib><creatorcontrib>Somsouk, Ma, MD</creatorcontrib><creatorcontrib>Sewell, Justin L., MD, MPH</creatorcontrib><creatorcontrib>Day, Lukejohn W., MD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Gastrointestinal endoscopy</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kouanda, Abdul M., MD</au><au>Somsouk, Ma, MD</au><au>Sewell, Justin L., MD, MPH</au><au>Day, Lukejohn W., MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Urgent colonoscopy in patients with lower GI bleeding: a systematic review and meta-analysis</atitle><jtitle>Gastrointestinal endoscopy</jtitle><addtitle>Gastrointest Endosc</addtitle><date>2017-07-01</date><risdate>2017</risdate><volume>86</volume><issue>1</issue><spage>107</spage><epage>117.e1</epage><pages>107-117.e1</pages><issn>0016-5107</issn><eissn>1097-6779</eissn><abstract>Background and Aims Lower GI bleeding (LGIB) is a common cause of morbidity and mortality. Colonoscopy is indicated in all hospitalized patients with LGIB, yet the time frame for performing colonoscopy remains unclear. Prior studies of outcomes in urgent versus elective colonoscopy have yielded conflicting results and were often underpowered. Our study objective was to compare several outcomes between urgent and elective colonoscopy in patients hospitalized for LGIB. Methods Systematic review and meta-analysis were performed on studies that compared urgent and elective colonoscopy in patients with LGIB. Pooled rates were calculated for specific outcomes, and rate ratios were determined for selected comparison groups. Results Twelve studies met inclusion criteria, with a total sample size of 10,172 patients in the urgent colonoscopy arm and 14,224 patients in the elective colonoscopy arm. Urgent colonoscopy was associated with increased use of endoscopic therapeutic intervention (RR, 1.70; 95% CI, 1.08-2.67). There were no significant differences in bleeding source localization (RR, 1.08; 95% CI, .92-1.25), adverse event rates (RR, 1.05; 95% CI, .65-1.71), rebleeding rates (RR, 1.14; 95% CI, .74-1.78), transfusion requirement (RR, 1.02; 95% CI, .73-1.41), or mortality (RR, 1.17; 95% CI, .45-3.02). Conclusions Urgent colonoscopy appears to be safe and well tolerated, but there is no clear evidence that it alters important clinical outcomes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28174123</pmid><doi>10.1016/j.gie.2017.01.035</doi><orcidid>https://orcid.org/0000-0002-7332-1898</orcidid></addata></record>
fulltext fulltext
identifier ISSN: 0016-5107
ispartof Gastrointestinal endoscopy, 2017-07, Vol.86 (1), p.107-117.e1
issn 0016-5107
1097-6779
language eng
recordid cdi_proquest_miscellaneous_1866293633
source ScienceDirect Freedom Collection
subjects Blood Transfusion
Colonoscopy - adverse effects
Elective Surgical Procedures
Emergencies
Gastroenterology and Hepatology
Gastrointestinal Hemorrhage - diagnostic imaging
Gastrointestinal Hemorrhage - mortality
Gastrointestinal Hemorrhage - therapy
Humans
Length of Stay - economics
Recurrence
title Urgent colonoscopy in patients with lower GI bleeding: a systematic review and meta-analysis
url http://sfxeu10.hosted.exlibrisgroup.com/loughborough?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-05T13%3A57%3A57IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_cross&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Urgent%20colonoscopy%20in%20patients%20with%20lower%20GI%20bleeding:%20a%C2%A0systematic%20review%20and%20meta-analysis&rft.jtitle=Gastrointestinal%20endoscopy&rft.au=Kouanda,%20Abdul%20M.,%20MD&rft.date=2017-07-01&rft.volume=86&rft.issue=1&rft.spage=107&rft.epage=117.e1&rft.pages=107-117.e1&rft.issn=0016-5107&rft.eissn=1097-6779&rft_id=info:doi/10.1016/j.gie.2017.01.035&rft_dat=%3Cproquest_cross%3E1866293633%3C/proquest_cross%3E%3Cgrp_id%3Ecdi_FETCH-LOGICAL-c408t-df905d99c98cbad6a68ac9c49d85f55ef8ad9ff8490b8e608a7bc2dcce2b7f3b3%3C/grp_id%3E%3Coa%3E%3C/oa%3E%3Curl%3E%3C/url%3E&rft_id=info:oai/&rft_pqid=1866293633&rft_id=info:pmid/28174123&rfr_iscdi=true