《Table 4 Clinical significance of performing contrast-enhanced computed tomography before colonoscop
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《Initial management for acute lower gastrointestinal bleeding》
1Patients with colonic diverticular bleeding who underwent contrast-enhanced computed tomography before colonoscopy.LGIB:Lower gastrointestinal bleeding;CE-CT:Contrast-enhanced computed tomography;SRH:Stigmata of recent hemorrhage;CS:Colonoscopy;UGIB:Uppe
Physicians must understand the predictive factors for severe LGIB to improve triage of appropriate patients for emergency hospitalization or early intervention.Several studies have investigated risk factors for adverse outcomes(rebleeding,severe bleeding,need for emergent hospitalization,need for intervention,adverse events,or death)in patients with acute LGIB[7,8,20-28].These include older age,presenting symptoms(no abdominal tenderness,no diarrhea,altered mental status,or blood on rectal examination),vital signs,comorbidities,medication use[nonsteroidal antiinflammatory drugs(NSAIDs)and antithrombotic agents],and laboratory data[hemoglobin(Hb),hematocrit,albumin,BUN,Cr,and prothrombin time(PT)](Table1).We also previously reported a predictive model of severe LGIB(NOBLADS score),which included NSAID use,no diarrhea,no abdominal tenderness,systolic blood pressure≤100 mmHg,albumin level<3.0 g/dL non-aspirin antiplatelet drug use,Charlson comorbidity index score≥2,and syncope[24].Several predictive models have been validated in other settings(Table 2)[21,22,24,27,28].Applying these models to manage LGIB could improve clinical outcomes and resource utilization.However,compared with established models of severe UGIB[29,30]such as the Blatchford score,predictive models of severe LGIB require further validation and improvements in accuracy.
图表编号 | XD0049328700 严禁用于非法目的 |
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绘制时间 | 2019.01.07 |
作者 | Tomonori Aoki、Yoshihiro Hirata、Atsuo Yamada、Kazuhiko Koike |
绘制单位 | Department of Gastroenterology, Graduate School of Medicine, the University of Tokyo、Division of Advanced Genome Medicine, the Institute of Medical Science,the University of Tokyo、Department of Gastroenterology, Graduate School of Medicine, the University |
更多格式 | 高清、无水印(增值服务) |