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Lower gastrointestinal bleeding: incidence, etiology, and outcomes in a population-based setting.

Hreinsson, Jóhann P; Gumundsson, Sveinn; Kalaitzakis, Evangelos LU and Björnsson, Einar S (2012) In European Journal of Gastroenterology and Hepathology
Abstract
OBJECTIVES:

To investigate the incidence and outcomes of acute lower gastrointestinal bleeding (ALGIB) in a population-based setting and examine the role of drugs potentially associated with GIB.



METHODS:

The study was prospective and population based. The cohort included all patients who underwent colonoscopy during the year 2010 at the National University Hospital of Iceland. Indications for endoscopies and drug history were recorded in a systematic manner. The inclusion criteria were overt bleeding leading to hospitalization or occurring in hospitalized patients. The use of NSAIDs, low-dose aspirin, warfarin, selective serotonin receptor inhibitors, and bisphosphonates before GIB was also checked... (More)
OBJECTIVES:

To investigate the incidence and outcomes of acute lower gastrointestinal bleeding (ALGIB) in a population-based setting and examine the role of drugs potentially associated with GIB.



METHODS:

The study was prospective and population based. The cohort included all patients who underwent colonoscopy during the year 2010 at the National University Hospital of Iceland. Indications for endoscopies and drug history were recorded in a systematic manner. The inclusion criteria were overt bleeding leading to hospitalization or occurring in hospitalized patients. The use of NSAIDs, low-dose aspirin, warfarin, selective serotonin receptor inhibitors, and bisphosphonates before GIB was also checked in a Pharmaceutical Database covering all drug prescriptions in the country. A control group included patients who underwent colonoscopy during the study period and did not have GIB.



RESULTS:

Altogether, 1134 patients underwent 1275 colonoscopies. Overall, 163 patients had ALGIB. The crude incidence for ALGIB was 87/100 000 inhabitants/year. The most common findings were diverticulosis (23%) and ischemic colitis (16%). A total of 7.4% of individuals had endoscopic therapy and none had undergone surgery. Two (1.2%) patients died because of ALGIB, both with severe comorbidities. Overall, 19% with ALGIB were on NSAIDs versus 9% in nonbleeders (P=0.0096); 37% with ALGIB were on low-dose aspirin versus 25% in nonbleeders (P=0.0222).



CONCLUSION:

The incidence for ALGIB is the highest reported to date. The most common reasons for ALGIB were diverticulosis and ischemic colitis. Mortality during hospitalization was very low. NSAIDs and low-dose aspirin seem to increase the risk for ALGIB. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
European Journal of Gastroenterology and Hepathology
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000311891400007
  • pmid:23013623
  • scopus:84870863443
ISSN
1473-5687
DOI
10.1097/MEG.0b013e32835948e3
language
English
LU publication?
yes
id
a6d3a23b-c384-4e09-84cb-0a1f48274a22 (old id 3123631)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/23013623?dopt=Abstract
date added to LUP
2012-10-03 21:01:37
date last changed
2017-10-01 04:58:40
@article{a6d3a23b-c384-4e09-84cb-0a1f48274a22,
  abstract     = {OBJECTIVES: <br/><br>
To investigate the incidence and outcomes of acute lower gastrointestinal bleeding (ALGIB) in a population-based setting and examine the role of drugs potentially associated with GIB. <br/><br>
<br/><br>
METHODS: <br/><br>
The study was prospective and population based. The cohort included all patients who underwent colonoscopy during the year 2010 at the National University Hospital of Iceland. Indications for endoscopies and drug history were recorded in a systematic manner. The inclusion criteria were overt bleeding leading to hospitalization or occurring in hospitalized patients. The use of NSAIDs, low-dose aspirin, warfarin, selective serotonin receptor inhibitors, and bisphosphonates before GIB was also checked in a Pharmaceutical Database covering all drug prescriptions in the country. A control group included patients who underwent colonoscopy during the study period and did not have GIB. <br/><br>
<br/><br>
RESULTS: <br/><br>
Altogether, 1134 patients underwent 1275 colonoscopies. Overall, 163 patients had ALGIB. The crude incidence for ALGIB was 87/100 000 inhabitants/year. The most common findings were diverticulosis (23%) and ischemic colitis (16%). A total of 7.4% of individuals had endoscopic therapy and none had undergone surgery. Two (1.2%) patients died because of ALGIB, both with severe comorbidities. Overall, 19% with ALGIB were on NSAIDs versus 9% in nonbleeders (P=0.0096); 37% with ALGIB were on low-dose aspirin versus 25% in nonbleeders (P=0.0222). <br/><br>
<br/><br>
CONCLUSION: <br/><br>
The incidence for ALGIB is the highest reported to date. The most common reasons for ALGIB were diverticulosis and ischemic colitis. Mortality during hospitalization was very low. NSAIDs and low-dose aspirin seem to increase the risk for ALGIB.},
  author       = {Hreinsson, Jóhann P and Gumundsson, Sveinn and Kalaitzakis, Evangelos and Björnsson, Einar S},
  issn         = {1473-5687},
  language     = {eng},
  month        = {09},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {European Journal of Gastroenterology and Hepathology},
  title        = {Lower gastrointestinal bleeding: incidence, etiology, and outcomes in a population-based setting.},
  url          = {http://dx.doi.org/10.1097/MEG.0b013e32835948e3},
  year         = {2012},
}