Predicting the need for urgent endoscopic intervention in lower gastrointestinal bleeding: a retrospective review

Area of Science:

• Gastroenterology
• Emergency Medicine
• Clinical Research

Background:

• Lower gastrointestinal bleeding (LGIB) frequently leads to emergency department visits and hospitalizations.
• Emerging evidence suggests outpatient evaluation may be safe for low-risk LGIB patients.
• Standardized criteria for identifying low-risk LGIB patients for outpatient management are lacking.

Purpose of the Study:

• To identify patient predictors associated with the need for urgent endoscopic intervention in lower gastrointestinal bleeding (LGIB).
• To establish criteria for risk stratification in LGIB patients presenting to the emergency department.

Main Methods:

• Retrospective chart review of 142 patients with LGIB.
• Data collection included demographics, clinical features, comorbidities, medications, hemodynamics, labs, and imaging.
• Statistical analyses included logistic regression, t-tests, Mann Whitney U, and Chi square tests.

Main Results:

• A hemoglobin drop greater than 20 g/L was the sole significant predictor of endoscopic intervention (p=0.030).
• Tachycardia, hypotension, and anticoagulation use were not significantly associated with the need for intervention (p>0.05).

Conclusions:

• A hemoglobin drop exceeding 20 g/L is the only identified patient parameter predicting the necessity for urgent endoscopic intervention in the emergency department setting for LGIB.
• This finding can assist in the early identification of LGIB patients requiring immediate endoscopic procedures.