Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study
Introduction: The impact of device-assisted enteroscopy (DAE) on long-term rebleeding in patients with obscure gastrointestinal bleeding (OGIB) exhibiting detectable small-bowel lesions remains unclear. We investigated the long-term rebleeding rate and predictive factors for DAE in patients with OGI...
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| Format: | Article |
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MDPI AG
2022-04-01
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| Series: | Diagnostics |
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| Online Access: | https://www.mdpi.com/2075-4418/12/4/954 |
| _version_ | 1797436037313593344 |
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| author | Yuna Kim Jae-Hyun Kim Eun-Ae Kang Soo-Jung Park Jae-Jun Park Jae-Hee Cheon Tae-Il Kim Jihye Park Seong-Ran Jeon |
| author_facet | Yuna Kim Jae-Hyun Kim Eun-Ae Kang Soo-Jung Park Jae-Jun Park Jae-Hee Cheon Tae-Il Kim Jihye Park Seong-Ran Jeon |
| author_sort | Yuna Kim |
| collection | DOAJ |
| description | Introduction: The impact of device-assisted enteroscopy (DAE) on long-term rebleeding in patients with obscure gastrointestinal bleeding (OGIB) exhibiting detectable small-bowel lesions remains unclear. We investigated the long-term rebleeding rate and predictive factors for DAE in patients with OGIB. Method: Patients with OGIB with small bowel lesions detected through DAE were enrolled at three Korean tertiary hospitals. Predictive risk factors associated with rebleeding were analyzed using the Cox regression analysis. Results: From April 2008 to April 2021, 141 patients were enrolled, including 38 patients (27.0%) with rebleeding. The rebleeding rates at 1, 2, and 3 years were 25.0%, 29.6%, and 31.1%, respectively. The Cox regression analysis revealed that multiple small-bowel lesions (hazard ratio [HR]: 2.551, 95% confidence interval [CI]: 1.157–5.627, <i>p</i> = 0.020), the need for more than five packed red blood cells (RBC) transfusions (HR: 2.704, 95% CI: 1.412–5.181, <i>p</i> = 0.003), and ulcerative lesions (HR: 1.992, 95% CI: 1.037–3.826, <i>p</i> = 0.039) were positively associated with rebleeding. Therapeutic interventions for patients with detectable lesions, overt bleeding (vs. occult bleeding), comorbidities, and medications were not associated with rebleeding. Conclusion: More than 25% of patients with OGIB having detectable small-bowel lesions had rebleeding. Patients with multiple lesions, a requirement of more than five packed RBC transfusions, and ulcerative lesions were associated with a higher risk of rebleeding. |
| first_indexed | 2024-03-09T10:56:53Z |
| format | Article |
| id | doaj.art-0842680731784f3aad3f4b4e2b7ff53f |
| institution | Directory Open Access Journal |
| issn | 2075-4418 |
| language | English |
| last_indexed | 2024-03-09T10:56:53Z |
| publishDate | 2022-04-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Diagnostics |
| spelling | doaj.art-0842680731784f3aad3f4b4e2b7ff53f2023-12-01T01:34:17ZengMDPI AGDiagnostics2075-44182022-04-0112495410.3390/diagnostics12040954Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter StudyYuna Kim0Jae-Hyun Kim1Eun-Ae Kang2Soo-Jung Park3Jae-Jun Park4Jae-Hee Cheon5Tae-Il Kim6Jihye Park7Seong-Ran Jeon8Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Gastroenterology, Department of Internal Medicine, Kosin University College of Medicine, Busan 49267, KoreaDepartment of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, KoreaDepartment of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 03722, KoreaInstitute for Digestive Research, Digestive Disease Center, Soonchunhyang University College of Medicine, Seoul 04401, KoreaIntroduction: The impact of device-assisted enteroscopy (DAE) on long-term rebleeding in patients with obscure gastrointestinal bleeding (OGIB) exhibiting detectable small-bowel lesions remains unclear. We investigated the long-term rebleeding rate and predictive factors for DAE in patients with OGIB. Method: Patients with OGIB with small bowel lesions detected through DAE were enrolled at three Korean tertiary hospitals. Predictive risk factors associated with rebleeding were analyzed using the Cox regression analysis. Results: From April 2008 to April 2021, 141 patients were enrolled, including 38 patients (27.0%) with rebleeding. The rebleeding rates at 1, 2, and 3 years were 25.0%, 29.6%, and 31.1%, respectively. The Cox regression analysis revealed that multiple small-bowel lesions (hazard ratio [HR]: 2.551, 95% confidence interval [CI]: 1.157–5.627, <i>p</i> = 0.020), the need for more than five packed red blood cells (RBC) transfusions (HR: 2.704, 95% CI: 1.412–5.181, <i>p</i> = 0.003), and ulcerative lesions (HR: 1.992, 95% CI: 1.037–3.826, <i>p</i> = 0.039) were positively associated with rebleeding. Therapeutic interventions for patients with detectable lesions, overt bleeding (vs. occult bleeding), comorbidities, and medications were not associated with rebleeding. Conclusion: More than 25% of patients with OGIB having detectable small-bowel lesions had rebleeding. Patients with multiple lesions, a requirement of more than five packed RBC transfusions, and ulcerative lesions were associated with a higher risk of rebleeding.https://www.mdpi.com/2075-4418/12/4/954enteroscopyobscure gastrointestinal bleedingrebleedingrisk factor |
| spellingShingle | Yuna Kim Jae-Hyun Kim Eun-Ae Kang Soo-Jung Park Jae-Jun Park Jae-Hee Cheon Tae-Il Kim Jihye Park Seong-Ran Jeon Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study Diagnostics enteroscopy obscure gastrointestinal bleeding rebleeding risk factor |
| title | Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study |
| title_full | Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study |
| title_fullStr | Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study |
| title_full_unstemmed | Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study |
| title_short | Rebleeding Rate and Risk Factors for Rebleeding after Device-Assisted Enteroscopy in Patients with Obscure Gastrointestinal Bleeding: A KASID Multicenter Study |
| title_sort | rebleeding rate and risk factors for rebleeding after device assisted enteroscopy in patients with obscure gastrointestinal bleeding a kasid multicenter study |
| topic | enteroscopy obscure gastrointestinal bleeding rebleeding risk factor |
| url | https://www.mdpi.com/2075-4418/12/4/954 |
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