ArticleWorld journal of gastrointestinal endoscopy2021
Endoscopic hemostasis makes the difference: Angiographic treatment in patients with lower gastrointestinal bleeding.
Article in World journal of gastrointestinal endoscopy, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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7 authors at 4 institutions in 1 country.
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Abstract
backgroundThe large majority of gastrointestinal bleedings subside on their own or after endoscopic treatment. However, a small number of these may pose a challenge in terms of therapy because the patients develop hemodynamic instability, and endoscopy does not achieve adequate hemostasis. Interventional radiology supplemented with catheter angiography (CA) and transarterial embolization have gained importance in recent times.
aimTo evaluate clinical predictors for angiography in patients with lower gastrointestinal bleeding (LGIB).
methodsWe compared two groups of patients in a retrospective analysis. One group had been treated for more than 10 years with CA for LGIB (
resultsPatients in the CA group had a higher shock index, a higher Glasgow-Blatchford bleeding score (GBS), lower serum hemoglobin levels, and more rarely achieved hemostasis in primary endoscopy. These patients needed more transfusions, had longer hospital stays, and had to undergo subsequent surgery more frequently (
conclusionEndoscopic hemostasis proved to be the crucial difference between the two patient groups. Primary endoscopic hemostasis, along with GBS and the number of transfusions, would permit a stratification of risks. After prospective confirmation of the present findings, the use of decision trees would permit the identification of patients at risk for subsequent diagnosis and treatment based on interventional radiology.
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