Literature DB >> 21320640

Factors that contribute to blood loss in patients with colonic angiodysplasia from a population-based study.

Naomi G Diggs1, Jennifer L Holub, David A Lieberman, Glenn M Eisen, Lisa L Strate.   

Abstract

BACKGROUND & AIMS: Most studies of angiodysplasia are small and performed at a single center. We investigated the epidemiology and management of colonic angiodysplasia by using a national endoscopy database.
METHODS: Colonoscopy reports (n = 229,727; generated from January 2000 to December 2002) from patients with documented angiodysplasia (n = 4159) were retrieved from the Clinical Outcomes Research Initiative. Predictors of occult or overt blood loss and endoscopic treatment were identified by using multivariate logistic regression.
RESULTS: Most patients with documented angiodysplasia were older than 60 years (73%) or had right-sided lesions (62%). There was evidence of blood loss in 56% of patients with angiodysplasia. Predictors of blood loss included inpatient status (odds ratio [OR], 8.74; 95% confidence interval [CI], 5.42-14.10), 2-10 angiodysplasias (OR, 1.50; 95% CI, 1.29-1.75), more than 10 lesions (OR, 2.18; 95% CI, 1.69-2.80), black race (OR, 1.95; 95% CI, 1.46-2.62), severe illness (OR, 1.97; 95% CI, 1.62-2.41), Hispanic ethnicity (OR, 1.71; 95% CI, 1.32-2.22), and age older than 80 years (OR, 1.32; 95% CI, 1.06-1.63). Endoscopic therapy was given to 28% of patients with evidence of blood loss and in 68% with active bleeding. Endoscopic treatment increased among patients in a university practice setting (vs community setting, OR, 2.53; 95% CI, 1.96-3.27) and decreased in Northwest geographic locations (vs Southwest, OR, 0.60; 95% CI, 0.43-0.84).
CONCLUSIONS: Predictors of blood loss in patients with colonic angiodysplasia include inpatient status, comorbidities, age, race/ethnicity, and lesion number. Endoscopic therapy for angiodysplasia varied according to practice setting and region.
Copyright © 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

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Year:  2011        PMID: 21320640      PMCID: PMC3853115          DOI: 10.1016/j.cgh.2011.02.003

Source DB:  PubMed          Journal:  Clin Gastroenterol Hepatol        ISSN: 1542-3565            Impact factor:   11.382


  21 in total

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Authors:  M Heer; H Sulser; A Hany
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Authors:  S J Boley; R Sammartano; A Adams; A DiBiase; S Kleinhaus; S Sprayregen
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8.  Angiodysplasia--an uncommon cause of colonic bleeding: colonoscopic evaluation of 1,050 patients with rectal bleeding and anaemia.

Authors:  B J Danesh; C Spiliadis; C B Williams; C M Zambartas
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Authors:  J C Santos; F Aprilli; A S Guimaräes; J J Rocha
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