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Early feeding reduces length of hospital stay in patients with acute lower gastrointestinal bleeding: A large multicentre cohort study

AimNo studies have compared the clinical outcomes of early and delayed feeding in patients with acute lower gastrointestinal bleeding (ALGIB). This study aimed to evaluate the benefits and risks of early feeding in a nationwide cohort of patients with ALGIB in whom haemostasis was achieved.MethodsWe...

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Published in:Colorectal disease 2023-11, Vol.25 (11), p.2206-2216
Main Authors: Kishino, Takaaki, Aoki, Tomonori, Sadashima, Eiji, Kobayashi, Katsumasa, Yamauchi, Atsushi, Yamada, Atsuo, Omori, Jun, Ikeya, Takashi, Aoyama, Taiki, Tominaga, Naoyuki, Sato, Yoshinori, Ishii, Naoki, Sawada, Tsunaki, Murata, Masaki, Takao, Akinari, Mizukami, Kazuhiro, Kinjo, Ken, Fujimori, Shunji, Uotani, Takahiro, Fujita, Minoru, Sato, Hiroki, Suzuki, Sho, Narasaka, Toshiaki, Hayasaka, Junnosuke, Funabiki, Tomohiro, Kinjo, Yuzuru, Mizuki, Akira, Kiyotoki, Shu, Mikami, Tatsuya, Gushima, Ryosuke, Fujii, Hiroyuki, Fuyuno, Yuta, Gunji, Naohiko, Toya, Yosuke, Narimatsu, Kazuyuki, Manabe, Noriaki, Nagaike, Koji, Kinjo, Tetsu, Sumida, Yorinobu, Funakoshi, Sadahiro, Kobayashi, Kiyonori, Matsuhashi, Tamotsu, Komaki, Yuga, Kaise, Mitsuru, Nagata, Naoyoshi
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container_title Colorectal disease
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creator Kishino, Takaaki
Aoki, Tomonori
Sadashima, Eiji
Kobayashi, Katsumasa
Yamauchi, Atsushi
Yamada, Atsuo
Omori, Jun
Ikeya, Takashi
Aoyama, Taiki
Tominaga, Naoyuki
Sato, Yoshinori
Ishii, Naoki
Sawada, Tsunaki
Murata, Masaki
Takao, Akinari
Mizukami, Kazuhiro
Kinjo, Ken
Fujimori, Shunji
Uotani, Takahiro
Fujita, Minoru
Sato, Hiroki
Suzuki, Sho
Narasaka, Toshiaki
Hayasaka, Junnosuke
Funabiki, Tomohiro
Kinjo, Yuzuru
Mizuki, Akira
Kiyotoki, Shu
Mikami, Tatsuya
Gushima, Ryosuke
Fujii, Hiroyuki
Fuyuno, Yuta
Gunji, Naohiko
Toya, Yosuke
Narimatsu, Kazuyuki
Manabe, Noriaki
Nagaike, Koji
Kinjo, Tetsu
Sumida, Yorinobu
Funakoshi, Sadahiro
Kobayashi, Kiyonori
Matsuhashi, Tamotsu
Komaki, Yuga
Kaise, Mitsuru
Nagata, Naoyoshi
description AimNo studies have compared the clinical outcomes of early and delayed feeding in patients with acute lower gastrointestinal bleeding (ALGIB). This study aimed to evaluate the benefits and risks of early feeding in a nationwide cohort of patients with ALGIB in whom haemostasis was achieved.MethodsWe reviewed data for 5910 patients with ALGIB in whom haemostasis was achieved and feeding was resumed within 3 days after colonoscopy at 49 hospitals across Japan (CODE BLUE‐J Study). Patients were divided into an early feeding group (≤1 day, n = 3324) and a delayed feeding group (2–3 days, n = 2586). Clinical outcomes were compared between the groups by propensity matching analysis of 1508 pairs.ResultsThere was no significant difference between the early and delayed feeding groups in the rebleeding rate within 7 days after colonoscopy (9.4% vs. 8.0%; p = 0.196) or in the rebleeding rate within 30 days (11.4% vs. 11.5%; p = 0.909). There was also no significant between‐group difference in the need for interventional radiology or surgery or in mortality. However, the median length of hospital stay after colonoscopy was significantly shorter in the early feeding group (5 vs. 7 days; p 
doi_str_mv 10.1111/codi.16751
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This study aimed to evaluate the benefits and risks of early feeding in a nationwide cohort of patients with ALGIB in whom haemostasis was achieved.MethodsWe reviewed data for 5910 patients with ALGIB in whom haemostasis was achieved and feeding was resumed within 3 days after colonoscopy at 49 hospitals across Japan (CODE BLUE‐J Study). Patients were divided into an early feeding group (≤1 day, n = 3324) and a delayed feeding group (2–3 days, n = 2586). Clinical outcomes were compared between the groups by propensity matching analysis of 1508 pairs.ResultsThere was no significant difference between the early and delayed feeding groups in the rebleeding rate within 7 days after colonoscopy (9.4% vs. 8.0%; p = 0.196) or in the rebleeding rate within 30 days (11.4% vs. 11.5%; p = 0.909). There was also no significant between‐group difference in the need for interventional radiology or surgery or in mortality. However, the median length of hospital stay after colonoscopy was significantly shorter in the early feeding group (5 vs. 7 days; p &lt; 0.001). These results were unchanged when subgroups of presumptive and definitive colonic diverticular bleeding were compared.ConclusionThe findings of this nationwide study suggest that early feeding after haemostasis can shorten the hospital stay in patients with ALGIB without increasing the risk of rebleeding.</description><identifier>ISSN: 1462-8910</identifier><identifier>EISSN: 1463-1318</identifier><identifier>DOI: 10.1111/codi.16751</identifier><language>eng</language><publisher>Chichester: Wiley Subscription Services, Inc</publisher><subject>Bleeding ; Clinical outcomes ; Colon ; Colonoscopy ; Feeding ; Length of stay ; Patients</subject><ispartof>Colorectal disease, 2023-11, Vol.25 (11), p.2206-2216</ispartof><rights>2023. This article is published under http://creativecommons.org/licenses/by/4.0/ (the “License”). 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This study aimed to evaluate the benefits and risks of early feeding in a nationwide cohort of patients with ALGIB in whom haemostasis was achieved.MethodsWe reviewed data for 5910 patients with ALGIB in whom haemostasis was achieved and feeding was resumed within 3 days after colonoscopy at 49 hospitals across Japan (CODE BLUE‐J Study). Patients were divided into an early feeding group (≤1 day, n = 3324) and a delayed feeding group (2–3 days, n = 2586). Clinical outcomes were compared between the groups by propensity matching analysis of 1508 pairs.ResultsThere was no significant difference between the early and delayed feeding groups in the rebleeding rate within 7 days after colonoscopy (9.4% vs. 8.0%; p = 0.196) or in the rebleeding rate within 30 days (11.4% vs. 11.5%; p = 0.909). There was also no significant between‐group difference in the need for interventional radiology or surgery or in mortality. However, the median length of hospital stay after colonoscopy was significantly shorter in the early feeding group (5 vs. 7 days; p &lt; 0.001). These results were unchanged when subgroups of presumptive and definitive colonic diverticular bleeding were compared.ConclusionThe findings of this nationwide study suggest that early feeding after haemostasis can shorten the hospital stay in patients with ALGIB without increasing the risk of rebleeding.</description><subject>Bleeding</subject><subject>Clinical outcomes</subject><subject>Colon</subject><subject>Colonoscopy</subject><subject>Feeding</subject><subject>Length of 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of hospital stay in patients with acute lower gastrointestinal bleeding: A large multicentre cohort study</atitle><jtitle>Colorectal disease</jtitle><date>2023-11-01</date><risdate>2023</risdate><volume>25</volume><issue>11</issue><spage>2206</spage><epage>2216</epage><pages>2206-2216</pages><issn>1462-8910</issn><eissn>1463-1318</eissn><abstract>AimNo studies have compared the clinical outcomes of early and delayed feeding in patients with acute lower gastrointestinal bleeding (ALGIB). This study aimed to evaluate the benefits and risks of early feeding in a nationwide cohort of patients with ALGIB in whom haemostasis was achieved.MethodsWe reviewed data for 5910 patients with ALGIB in whom haemostasis was achieved and feeding was resumed within 3 days after colonoscopy at 49 hospitals across Japan (CODE BLUE‐J Study). Patients were divided into an early feeding group (≤1 day, n = 3324) and a delayed feeding group (2–3 days, n = 2586). Clinical outcomes were compared between the groups by propensity matching analysis of 1508 pairs.ResultsThere was no significant difference between the early and delayed feeding groups in the rebleeding rate within 7 days after colonoscopy (9.4% vs. 8.0%; p = 0.196) or in the rebleeding rate within 30 days (11.4% vs. 11.5%; p = 0.909). There was also no significant between‐group difference in the need for interventional radiology or surgery or in mortality. However, the median length of hospital stay after colonoscopy was significantly shorter in the early feeding group (5 vs. 7 days; p &lt; 0.001). These results were unchanged when subgroups of presumptive and definitive colonic diverticular bleeding were compared.ConclusionThe findings of this nationwide study suggest that early feeding after haemostasis can shorten the hospital stay in patients with ALGIB without increasing the risk of rebleeding.</abstract><cop>Chichester</cop><pub>Wiley Subscription Services, Inc</pub><doi>10.1111/codi.16751</doi><tpages>11</tpages><orcidid>https://orcid.org/0000-0002-1620-5575</orcidid><orcidid>https://orcid.org/0000-0002-6302-5059</orcidid><orcidid>https://orcid.org/0000-0002-5501-3787</orcidid><oa>free_for_read</oa></addata></record>
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identifier ISSN: 1462-8910
ispartof Colorectal disease, 2023-11, Vol.25 (11), p.2206-2216
issn 1462-8910
1463-1318
language eng
recordid cdi_proquest_miscellaneous_2872180901
source Wiley
subjects Bleeding
Clinical outcomes
Colon
Colonoscopy
Feeding
Length of stay
Patients
title Early feeding reduces length of hospital stay in patients with acute lower gastrointestinal bleeding: A large multicentre cohort study
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