Acute lower gastrointestinal bleeding : A population-based five-year follow-up study
Publisher Copyright: © Author(s) 2019. Background: Data on the natural history of acute lower gastrointestinal bleeding (ALGIB) are lacking. We evaluated five-year bleeding risk and mortality in ALGIB patients and controls. Furthermore, we aimed to find predictors of rebleeding. Methods: This was a...
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ftopinvisindi:oai:opinvisindi.is:20.500.11815/3617 2023-05-15T16:52:07+02:00 Acute lower gastrointestinal bleeding : A population-based five-year follow-up study Hreinsson, Johann P. Ægisdottir, Silja Björnsson, Einar Stefán Office of Division of Clinical Services I Faculty of Medicine Landspitali - The National University Hospital of Iceland 2019-12-01 7 1330-1336 https://hdl.handle.net/20.500.11815/3617 https://doi.org/10.1177/2050640619863517 en eng United European Gastroenterology Journal; 7(10) http://www.scopus.com/inward/record.url?scp=85068902848&partnerID=8YFLogxK Hreinsson , J P , Ægisdottir , S & Björnsson , E S 2019 , ' Acute lower gastrointestinal bleeding : A population-based five-year follow-up study ' , United European Gastroenterology Journal , vol. 7 , no. 10 , pp. 1330-1336 . https://doi.org/10.1177/2050640619863517 2050-6406 PURE: 37959968 PURE UUID: 30e3fa73-3a61-4a98-a9d0-c129e18c4530 Scopus: 85068902848 https://hdl.handle.net/20.500.11815/3617 31839958 https://doi.org/10.1177/2050640619863517 info:eu-repo/semantics/openAccess Bráðalæknisfræði Meltingarlæknisfræði Gastrointestinal haemorrhage GI bleeding outcome GI bleeding prognosis GI rebleeding risk factors natural history of GI bleeding Oncology Gastroenterology /dk/atira/pure/researchoutput/researchoutputtypes/contributiontojournal/article 2019 ftopinvisindi https://doi.org/20.500.11815/3617 https://doi.org/10.1177/2050640619863517 2022-11-18T06:52:28Z Publisher Copyright: © Author(s) 2019. Background: Data on the natural history of acute lower gastrointestinal bleeding (ALGIB) are lacking. We evaluated five-year bleeding risk and mortality in ALGIB patients and controls. Furthermore, we aimed to find predictors of rebleeding. Methods: This was a population-based retrospective case-control study conducted at the National University Hospital of Iceland, and included every individual who underwent endoscopy in 2010–2011. ALGIB was defined as rectal bleeding leading to hospitalisation or occurring in a hospitalised patient. Controls were randomly selected from those who underwent endoscopy in the same time period but who did not have GIB, and were matched for sex and age. Patients were followed up five years after index bleeding. Rebleeding was defined as ALGIB >14 days after index bleeding. Results: In total, 2294 patients underwent 2602 colonoscopies in 2010–2011. Of those, 319 (14%) had ALGIB. The mean age for cases and controls was 64 and 65 years (±19.3–20.7), respectively, and females accounted for 51–52% of the study population. For ALGIB patients, the five-year risk of a bleeding was 20% (95% confidence interval (CI) 15–24%) compared to 3% (95% CI 1–5%) in controls (log rank < 0.0001; co-morbidity-adjusted hazard ratio (HR) 6.9 (95% CI 3.4–14)). Only 37% of bleeders had the same cause of index bleeding and rebleeding. In ALGIB patients, age and inflammatory bowel disease (IBD) were predictors of rebleeding, with odds ratios per 10 years of 1.3 (95% CI 1.1–1.6) and 4.3 (95% CI 1.5–12), respectively. Bleeders did not have a higher risk of five-year mortality compared to controls (HR = 1.2; 95% CI 0.87–1.6). Conclusions: One fifth of ALGIB patients had rebleeding during follow-up. Age and IBD were independent predictors of rebleeding. ALGIB was not associated with lower five-year survival. Peer reviewed Article in Journal/Newspaper Iceland Opin vísindi (Iceland) United European Gastroenterology Journal 7 10 1330 1336 |
institution |
Open Polar |
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Opin vísindi (Iceland) |
op_collection_id |
ftopinvisindi |
language |
English |
topic |
Bráðalæknisfræði Meltingarlæknisfræði Gastrointestinal haemorrhage GI bleeding outcome GI bleeding prognosis GI rebleeding risk factors natural history of GI bleeding Oncology Gastroenterology |
spellingShingle |
Bráðalæknisfræði Meltingarlæknisfræði Gastrointestinal haemorrhage GI bleeding outcome GI bleeding prognosis GI rebleeding risk factors natural history of GI bleeding Oncology Gastroenterology Hreinsson, Johann P. Ægisdottir, Silja Björnsson, Einar Stefán Acute lower gastrointestinal bleeding : A population-based five-year follow-up study |
topic_facet |
Bráðalæknisfræði Meltingarlæknisfræði Gastrointestinal haemorrhage GI bleeding outcome GI bleeding prognosis GI rebleeding risk factors natural history of GI bleeding Oncology Gastroenterology |
description |
Publisher Copyright: © Author(s) 2019. Background: Data on the natural history of acute lower gastrointestinal bleeding (ALGIB) are lacking. We evaluated five-year bleeding risk and mortality in ALGIB patients and controls. Furthermore, we aimed to find predictors of rebleeding. Methods: This was a population-based retrospective case-control study conducted at the National University Hospital of Iceland, and included every individual who underwent endoscopy in 2010–2011. ALGIB was defined as rectal bleeding leading to hospitalisation or occurring in a hospitalised patient. Controls were randomly selected from those who underwent endoscopy in the same time period but who did not have GIB, and were matched for sex and age. Patients were followed up five years after index bleeding. Rebleeding was defined as ALGIB >14 days after index bleeding. Results: In total, 2294 patients underwent 2602 colonoscopies in 2010–2011. Of those, 319 (14%) had ALGIB. The mean age for cases and controls was 64 and 65 years (±19.3–20.7), respectively, and females accounted for 51–52% of the study population. For ALGIB patients, the five-year risk of a bleeding was 20% (95% confidence interval (CI) 15–24%) compared to 3% (95% CI 1–5%) in controls (log rank < 0.0001; co-morbidity-adjusted hazard ratio (HR) 6.9 (95% CI 3.4–14)). Only 37% of bleeders had the same cause of index bleeding and rebleeding. In ALGIB patients, age and inflammatory bowel disease (IBD) were predictors of rebleeding, with odds ratios per 10 years of 1.3 (95% CI 1.1–1.6) and 4.3 (95% CI 1.5–12), respectively. Bleeders did not have a higher risk of five-year mortality compared to controls (HR = 1.2; 95% CI 0.87–1.6). Conclusions: One fifth of ALGIB patients had rebleeding during follow-up. Age and IBD were independent predictors of rebleeding. ALGIB was not associated with lower five-year survival. Peer reviewed |
author2 |
Office of Division of Clinical Services I Faculty of Medicine Landspitali - The National University Hospital of Iceland |
format |
Article in Journal/Newspaper |
author |
Hreinsson, Johann P. Ægisdottir, Silja Björnsson, Einar Stefán |
author_facet |
Hreinsson, Johann P. Ægisdottir, Silja Björnsson, Einar Stefán |
author_sort |
Hreinsson, Johann P. |
title |
Acute lower gastrointestinal bleeding : A population-based five-year follow-up study |
title_short |
Acute lower gastrointestinal bleeding : A population-based five-year follow-up study |
title_full |
Acute lower gastrointestinal bleeding : A population-based five-year follow-up study |
title_fullStr |
Acute lower gastrointestinal bleeding : A population-based five-year follow-up study |
title_full_unstemmed |
Acute lower gastrointestinal bleeding : A population-based five-year follow-up study |
title_sort |
acute lower gastrointestinal bleeding : a population-based five-year follow-up study |
publishDate |
2019 |
url |
https://hdl.handle.net/20.500.11815/3617 https://doi.org/10.1177/2050640619863517 |
genre |
Iceland |
genre_facet |
Iceland |
op_relation |
United European Gastroenterology Journal; 7(10) http://www.scopus.com/inward/record.url?scp=85068902848&partnerID=8YFLogxK Hreinsson , J P , Ægisdottir , S & Björnsson , E S 2019 , ' Acute lower gastrointestinal bleeding : A population-based five-year follow-up study ' , United European Gastroenterology Journal , vol. 7 , no. 10 , pp. 1330-1336 . https://doi.org/10.1177/2050640619863517 2050-6406 PURE: 37959968 PURE UUID: 30e3fa73-3a61-4a98-a9d0-c129e18c4530 Scopus: 85068902848 https://hdl.handle.net/20.500.11815/3617 31839958 https://doi.org/10.1177/2050640619863517 |
op_rights |
info:eu-repo/semantics/openAccess |
op_doi |
https://doi.org/20.500.11815/3617 https://doi.org/10.1177/2050640619863517 |
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United European Gastroenterology Journal |
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