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Risk factors and the role of bedside colonoscopy for lower gastrointestinal hemorrhage in critically ill patients

Authors
 Kim BC  ;  Cheon JH  ;  Kim TI  ;  Kim WH 
Citation
 HEPATO-GASTROENTEROLOGY, Vol.55(88) : 2108-2111, 2008 
Journal Title
 HEPATO-GASTROENTEROLOGY 
ISSN
 0172-6390 
Issue Date
2008
MeSH
Adult ; Aged ; Aged, 80 and over ; Colonoscopy*/methods ; Critical Illness ; Female ; Gastrointestinal Hemorrhage/diagnosis* ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors
Keywords
Adult ; Aged ; Aged, 80 and over ; Colonoscopy*/methods ; Critical Illness ; Female ; Gastrointestinal Hemorrhage/diagnosis* ; Humans ; Intensive Care Units ; Male ; Middle Aged ; Retrospective Studies ; Risk Factors
Abstract
BACKGROUND/AIMS: We designed this study to determine the clinical characteristics of critically ill patients with lower gastrointestinal hemorrhage (LGIH) and to evaluate the effectiveness of bedside colonoscopy in diagnosing and managing LGIH in the intensive care unit (ICU) setting. METHODOLOGY: We retrospectively reviewed the medical records of patients who underwent bedside colonoscopy for LGIH that developed while in the ICU at Severance Hospital from January 1999 to June 2006. The control group was a random sampling of patients hospitalized in the ICU without GIH. RESULTS: A total of 28,101 patients were hospitalized in ICU during the study period. Of these, 43 patients were included in each group. There were no significant differences in age, sex, and primary and underlying diseases between the two groups. Hypoalbuminemia and high BUN levels were found to be risk factors for LGIH in ICU patients. Bleeding focus was recognized in 28 patients (65.1%) through bedside colonoscopy. Major endoscopic diagnoses were ischemic colitis (13, 30.2%), rectal ulcer (7, 20.9%), and hemorrhoids (6, 13.9%). Primary endoscopic hemostasis was achieved in 11 of 28 diagnosed patients (39.3%). CONCLUSIONS: Our data suggest that patients' underlying conditions may affect LGIH in the ICU setting. Moreover, urgent bedside colonoscopy may be effective in diagnosing and guiding appropriate treatments for LGIH in critically ill patients.
DOI
19260486
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Byung Chang(김병창)
Kim, Won Ho(김원호) ORCID logo https://orcid.org/0000-0002-5682-9972
Kim, Tae Il(김태일) ORCID logo https://orcid.org/0000-0003-4807-890X
Cheon, Jae Hee(천재희) ORCID logo https://orcid.org/0000-0002-2282-8904
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/108279
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