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Risk factors and outcomes of acute lower gastrointestinal bleeding in intestinal Behçet's disease

Authors
 Jihye Park  ;  Jae Hee Cheon  ;  Yong Eun Park  ;  Yoon Jee Lee  ;  Hyun Jung Lee  ;  Soo Jung Park  ;  Sung Pil Hong  ;  Tae Il Kim  ;  Won Ho Kim 
Citation
 International Journal of Colorectal Disease, Vol.32(5) : 745-751, 2017 
Journal Title
 International Journal of Colorectal Disease 
ISSN
 0179-1958 
Issue Date
2017
MeSH
Acute Disease ; Behcet Syndrome/complications* ; Behcet Syndrome/epidemiology ; Behcet Syndrome/therapy* ; Female ; Gastrointestinal Hemorrhage/complications* ; Gastrointestinal Hemorrhage/epidemiology ; Gastrointestinal Hemorrhage/therapy* ; Humans ; Intestinal Diseases/complications* ; Intestinal Diseases/epidemiology ; Intestinal Diseases/therapy* ; Male ; Middle Aged ; Prevalence ; Proportional Hazards Models ; Risk Factors ; Treatment Outcome
Keywords
Behçet’s disease ; Gastrointestinal hemorrhage ; Outcome ; Rebleeding ; Risk factor
Abstract
BACKGROUND: Intestinal Behçet's disease (BD) can cause acute lower gastrointestinal bleeding, which is sometimes fatal. AIM: We aimed to identify the risk factors and outcomes of acute lower gastrointestinal bleeding and factors associated with rebleeding in intestinal BD patients. METHODS: Of the total of 588 intestinal BD patients, we retrospectively reviewed the medical records of 66 (11.2%) patients with acute lower gastrointestinal bleeding and compared them with those of 132 matched patients without bleeding. RESULTS: The baseline characteristics were comparable between the bleeding group (n = 66) and the non-bleeding group (n = 132). On multivariate analysis, the independent factors significantly associated with lower gastrointestinal bleeding were older age (>52 years) (hazard ratio [HR] 2.2, 95% confidence interval [CI] 1.058-4.684, p = 0.035) and a nodular ulcer margin (HR 7.1, 95% CI 2.084-24.189, p = 0.002). Rebleeding occurred in 23 patients (34.8%). Female patients (p = 0.044) and those with previous use of corticosteroids or azathioprine (p = 0.034) were more likely to develop rebleeding. On multivariate analysis, only use of steroids or azathioprine was significantly associated with rebleeding (HR 3.2, 95% CI 1.070-9.462, p = 0.037). CONCLUSIONS: Age >52 years and the presence of a nodular margin of the ulcer were found to be related to increased risk of bleeding in patients with intestinal BD. Rebleeding is not uncommon and not effectively prevented with currently available medications. Further studies are warranted to identify effective measures to decrease rebleeding in intestinal BD.
Full Text
https://link.springer.com/article/10.1007%2Fs00384-016-2728-x
DOI
10.1007/s00384-016-2728-x
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
Yonsei Authors
김원호(Kim, Won Ho)
김태일(Kim, Tae Il) ORCID logo https://orcid.org/0000-0003-4807-890X
박수정(Park, Soo Jung)
박용은(Park, Yong Eun)
박지혜(Park, Ji Hye)
이윤지(Lee, Yoon Jee)
이현정(Lee, Hyun Jung)
천재희(Cheon, Jae Hee) ORCID logo https://orcid.org/0000-0002-2282-8904
홍성필(Hong, Sung Pil)
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URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/154210
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