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Risk of Rebleeding in Patients with Small Bowel Vascular Lesions
- Source :
- Internal Medicine
- Publication Year :
- 2021
- Publisher :
- The Japanese Society of Internal Medicine, 2021.
-
Abstract
- Background With recent advances in endoscopic modalities, small bowel vascular lesions (SBVLs) are often now detected in patients with gastrointestinal bleeding. Given the high invasiveness of endoscopic treatment, it is important to select patients at high risk for bleeding. Aim To assess the risk of rebleeding in patients with SBVLs as a systemic disease rather than a gastrointestinal disease in relation to their general health. Methods We retrospectively analyzed the clinical data of 55 patients with SBVLs among patients with obscure gastrointestinal bleeding. The possible association between the clinical findings and the updated Charlson comorbidity index with rebleeding was evaluated. Results Gastrointestinal rebleeding occurred in 20 patients (36.4%) during the follow-up period. The presence of multiple comorbidities as indicated by an updated Charlson comorbidity index of ≥4 was a risk factor for rebleeding (hazard ratio, 3.64; P = 0.004). Other risk factors were arteriosclerosis of the superior mesenteric artery and multiple SBVLs. Endoscopic hemostasis and the discontinuation of antithrombotic medications were not significantly associated with rebleeding. Patients with a high updated Charlson comorbidity index had a high risk of death of causes other than gastrointestinal rebleeding. Conclusions Gastrointestinal rebleeding is not a rare condition among patients with SBVLs. Patients with poor general health may therefore have a higher risk of rebleeding.
- Subjects :
- Gastrointestinal bleeding
medicine.medical_specialty
capsule endoscopy
gastrointestinal bleeding
Gastroenterology
law.invention
Capsule endoscopy
law
angioectasia
Recurrence
Internal medicine
small bowel
Antithrombotic
Intestine, Small
Internal Medicine
Medicine
Humans
Risk factor
Retrospective Studies
arteriosclerosis
business.industry
Hazard ratio
Hemostasis, Endoscopic
General Medicine
Arteriosclerosis
medicine.disease
Discontinuation
Gastrointestinal disease
Original Article
business
Charlson comorbidity index
Subjects
Details
- Language :
- English
- ISSN :
- 13497235 and 09182918
- Volume :
- 60
- Issue :
- 23
- Database :
- OpenAIRE
- Journal :
- Internal Medicine
- Accession number :
- edsair.doi.dedup.....557141ae4ce93b94195ee510d06b7dfd