Evidence map›Paper›PMID 39730771›Full record

ArticleJournal of gastroenterology2025

Impact of long-term trends on outcomes in the management of colonic diverticular bleeding: mediation analyses in a large multicenter study.

Kazuyuki Narimatsu, Naoki Ishii, Atsuo Yamada, Tomonori Aoki, Katsumasa Kobayashi, Atsushi Yamauchi, Jun Omori, Takashi Ikeya, Taiki Aoyama, Naoyuki Tominaga and 35 more

Abstract readMulticenter Study
PubMed Publisher
In one paragraph

Article in Journal of gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

45 authors.

Kazuyuki NarimatsuDepartment of Internal Medicine, National Defense Medical College, Tokorozawa-city, Saitama, Japan. narimaty@gmail.com.ORCID 0000-0002-1620-5575
Naoki IshiiDivision of Gastroenterology, Tokyo Shinagawa Hospital, Shinagawa-ku, Tokyo, Japan. naoishi0328@gmail.com.
Atsuo YamadaDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Tomonori AokiDepartment of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan.
Katsumasa KobayashiDepartment of Gastroenterology, Tokyo Metropolitan Bokutoh Hospital, Sumida-ku, Tokyo, Japan.
Atsushi YamauchiDepartment of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
Jun OmoriDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
Takashi IkeyaDepartment of Gastroenterology, St. Luke's International University, Chuo-ku, Tokyo, Japan.
Taiki AoyamaDepartment of Gastroenterology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
Naoyuki TominagaDepartment of Gastroenterology, Saga-Ken Medical Centre Koseikan, Saga, Japan.
Yoshinori SatoDivision of Gastroenterology, Department of Internal Medicine, St Marianna University School of Medicine, Kanagawa, Japan.
Takaaki KishinoDepartment of Gastroenterology and Hepatology, Center for Digestive and Liver Diseases, Nara city Hospital, Nara, Japan.
Tsunaki SawadaDepartment of Endoscopy, Nagoya University Hospital, Aichi, Japan.
Masaki MurataDepartment of Gastroenterology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan.
Akinari TakaoDepartment of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Bunkyo-ku, Tokyo, Japan.
Kazuhiro MizukamiDepartment of Gastroenterology, Oita University, Oita, Japan.
Ken KinjoDepartment of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
Shunji FujimoriDepartment of Gastroenterology, Nippon Medical School, Chiba Hokusoh Hospital, Chiba, Japan.
Takahiro UotaniDepartment of Gastroenterology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
Minoru FujitaDivision of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Center, Okayama, Japan.
Hiroki SatoDivision of Gastroenterology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
Sho SuzukiDepartment of Gastroenterology and Hepatology, Center for Digestive Disease and Division of Endoscopy, University of Miyazaki Hospital, Miyazaki, Japan.
Toshiaki NarasakaDepartment of Gastroenterology, University of Tsukuba, Ibaraki, Japan.
Junnosuke HayasakaDepartment of Gastroenterology, Toranomon Hospital, Minato-ku, Tokyo, Japan.
Tomohiro FunabikiDepartment of Emergency Medicine, Fujita Health University Hospital, Aichi, Japan.
Yuzuru KinjoDepartment of Gastroenterology, Naha City Hospital, Okinawa, Japan.
Akira MizukiDepartment of Internal Medicine, Tokyo Saiseikai Central Hospital, Minato-ku, Tokyo, Japan.
Shu KiyotokiDepartment of Gastroenterology, Shuto General Hospital, Yamaguchi, Japan.
Tatsuya MikamiDivision of Endoscopy, Hirosaki University Hospital, Aomori, Japan.
Ryosuke GushimaDepartment of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
Hiroyuki FujiiDepartment of Gastroenterology and Hepatology, National Hospital Organization Fukuokahigashi Medical Center, Fukuoka, Japan.
Yuta FuyunoDepartment of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Takuto HikichiDepartment of Endoscopy, Fukushima Medical University Hospital, Fukushima, Japan.
Yosuke ToyaDivision of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan.
Noriaki ManabeDivision of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Okayama, Japan.
Koji NagaikeDepartment of Gastroenterology and Hepatology, Suita Municipal Hospital, Osaka, Japan.
Tetsu KinjoDepartment of Endoscopy, University of the Ryukyus Hospital, Okinawa, Japan.
Yorinobu SumidaDepartment of Gastroenterology, National Hospital Organization Kyushu Medical Center, Fukuoka, Japan.
Sadahiro FunakoshiDepartment of Gastroenterological Endoscopy, Fukuoka University Hospital, Fukuoka, Japan.
Kiyonori KobayashiDepartment of Gastroenterology, School of Medicine, Kitasato University, Kanagawa, Japan.
Tamotsu MatsuhashiDepartment of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan.
Yuga KomakiDigestive and Lifestyle Diseases, and Hygiene and Health Promotion Medicine, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
Ryota HokariDepartment of Internal Medicine, National Defense Medical College, Tokorozawa-city, Saitama, Japan.
Mitsuru KaiseDepartment of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan.
Naoyoshi NagataDepartment of Gastroenterological Endoscopy, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite accumulating evidence and recommendations for management of colonic diverticular bleeding (CDB), the changes in its clinical management and outcomes remain unknown.

methodsWe performed a retrospective tendency analysis on a biennial basis, a propensity score-matched cohort study between the first and latter half groups, and mediation analyses to compare the diagnostic and treatment methods between January 2010 and December 2019 (CODE BLUE-J Study).

resultsA total of 6575 patients with CDB were included. While the use of colonoscopy as the initial diagnostic procedure declined, the use of computed tomography (CT) increased in both the trend test and before-and-after comparisons. In hemostasis therapy, the use of endoscopic clips declined and band ligation increased. Interventional radiology remained unchanged; however, the number of surgeries decreased over time. The stigmata of recent hemorrhage (SRH) detection rate and length of hospital stay (LOS) improved significantly. Mediation analyses showed that use of a distal attachment and water-jet scope contributed to an improved SRH detection rate, and use of band ligation contributed to preventing rebleeding within 30 days.

conclusionsManagement strategies for CDB have changed in the past decade, particularly regarding the increased use of CT and decreased need for surgery. However, the main outcomes, except for the SRH detection rate and LOS, did not improve. The widespread use of distal attachment, water-jet scope, and band ligation could improve outcomes in CDB management.

Indexed as

Diverticulum, ColonGastrointestinal HemorrhageAgedAged, 80 and overColonoscopyFemaleHemostasis, EndoscopicHumansLength of StayLigationMaleMiddle AgedPropensity ScoreRetrospective StudiesTomography, X-Ray ComputedTreatment OutcomeAcute hematocheziaColonic diverticular bleedingColonoscopyComputed tomographyEndoscopic therapyLength of hospital stayMediation analysisMortalityRebleedingTransfusion of packed red blood cells

Identifiers

PMID39730771

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.