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Rebleeding and survival after acute lower gastrointestinal bleeding
Thomas Anthony1, Pradeep Penta, Robert D Todd
1Department of Surgery, University of Texas Southwestern Medical Center and the VA North Texas Health Care System, 4500 South Lancaster Rd., Dallas, TX 75216, USA. Thomas.Anthony@med.va.gov
American Journal of Surgery
|November 18, 2004
Summary
Rebleeding after acute lower gastrointestinal bleeding (LGIB) is uncommon, affecting a small percentage of patients. While survival rates for LGIB are low, few deaths are directly caused by hemorrhage.
Area of Science:
- Gastroenterology
- Medical Outcomes Research
Background:
- Long-term outcome measurement in acute lower gastrointestinal bleeding (LGIB) is infrequently studied.
- Previous research has concentrated on LGIB evaluation and treatment strategies.
Purpose of the Study:
- To assess rebleeding and survival rates in patients experiencing acute lower gastrointestinal bleeding.
- To provide data on the long-term prognosis for LGIB patients.
Main Methods:
- Retrospective review of 119 patients who underwent technetium-labeled red blood cell scans for LGIB between 1997 and 2002.
- Rebleeding defined as bleeding requiring transfusion ≥2 weeks post-initial episode.
Main Results:
- The actuarial rebleeding rate was 15% at 2 years among 102 patients surviving >2 weeks.
- Thirty-day mortality was 18%, with a median survival of 60 months for the cohort.
- Few deaths were directly attributed to hemorrhage; most were due to surgical complications.
Conclusions:
- Rebleeding occurs in a minority of patients following an initial LGIB episode.
- Despite poor overall survival, LGIB is rarely the direct cause of death.