P0214 - Colonoscopy Within 3 Weeks May Reduce Mortality and Complications in Lower Gastrointestinal Bleeding: A Multicenter Retrospective Analysis

Rahul Pamarthy, MD¹, Waqas Rasheed, MD², Hassam Ali, MD³, Abddulazeez Swaiti, MD⁴, Shiza sarfraz, MD³, Umar Hayat, MD⁵, Dushyant S. Dahiya, MD⁶, Amna Iqbal, MD⁷, Mona A.. Ali, MD⁸, Syed Muhammad Ali Najafi, MBBS⁹, Muhammad Ayaz Tariz, ¹⁰, Manesh Kumar Gangwani, MD¹¹, Douglas Adler, MD^12
1East Carolina University, Greenville, NC; ²University of Kentucky, Lexington, KY; ³East Carolina University Brody School of Medicine, Greenville, NC; ⁴ECU Health, Greenville, NC; ⁵Geisinger Wyoming Valley Medical Center, Wilkes-Barre, PA; ⁶The University of Kansas School of Medicine, Kansas City, KS; ⁷University of Toledo Medical Center, Toledo, OH; ⁸Mansoura University, Mansoura, Ad Daqahliyah, Egypt; ⁹Services Institute of Medical Sciences, Lahore, Punjab, Pakistan; ¹⁰Quaid-e-Azam Medical College, Punjab, Punjab, Pakistan; ¹¹University of Toledo, Toledo, OH; ¹²Center for Advanced Therapeutic (CATE), Centura Health, Porter Adventist Hospital, Peak Gastroenterology, Denver, CO

Introduction: Lower gastrointestinal bleeding (LGIB) is a common cause of hospitalization among adults. The role of early colonoscopy (as opposed to inpatient) in managing LGIB remains debated. This study compares outcomes of LGIB-related hospitalizations in patients who underwent colonoscopy within three weeks of hospitalization to those who did not.

Methods: This retrospective cohort study utilized data from the TrinetX US Collaborative Network, focusing on adult patients hospitalized for LGIB, excluding diverticulitis with bleeding, from January 1, 2000, to June 1, 2024. The study setting was inpatient only. Patients were divided into two groups based on whether they received a colonoscopy within three weeks from presentation (cases) or not (controls). Propensity score matching (PSM) was performed using covariates including bio demographics and comorbidities in Table 1. Outcomes were compared within 30 days of hospitalization.

Results: After matching, each group had 18,784 hospitalizations. The mean age was slightly higher in the cases (60.7 ± 19.5 years) compared to the controls (60.2 ± 19.7 years, p=0.019). Gender distribution was similar across both groups, with 51.3% males. Racial distribution and most comorbidities were comparable between groups Table 1). Essential hypertension was more prevalent in the controls (54.2% vs. 52.6%, p=0.002), while liver disease (3.7% vs. 2.9%, p<0.001) and chronic kidney disease (15.1% vs. 13.8%, p<0.001) were more prevalent in the cases. Inpatient mortality was 0.79% in the cases vs. 1.21% in the controls (p<0.0001; OR: 0.64, 95% CI: 0.52-0.79. Patients who underwent colonoscopy within three weeks had a lower rate of hypovolemic/hemorrhagic shock (0.45% vs. 0.68%, p=0.003; OR: 0.66, 95% CI: 0.50-0.80); ICU level care (1.51% vs. 2.09%, p<0.0001; OR: 0.72, 95% CI: 0.61-0.84); blood transfusion (1.37% vs. 2.05%, p<0.0001; OR: 0.66, 95% CI: 0.56-0.78); and 30-day readmission (12.67% vs. 17.16%, p<0.0001; OR: 0.70, 95% CI: 0.66-0.74) (Figure 1).

Discussion: This study demonstrates that colonoscopy within three weeks in patients hospitalized for LGIB is associated with significantly better outcomes, including lower 30-day readmissions. This suggests that performing a colonoscopy within three weeks of lower gastrointestinal luminal bleeding may improve clinical outcomes.



Disclosures:


Rahul Pamarthy, MD¹, Waqas Rasheed, MD², Hassam Ali, MD³, Abddulazeez Swaiti, MD⁴, Shiza sarfraz, MD³, Umar Hayat, MD⁵, Dushyant S. Dahiya, MD⁶, Amna Iqbal, MD⁷, Mona A.. Ali, MD⁸, Syed Muhammad Ali Najafi, MBBS⁹, Muhammad Ayaz Tariz, ¹⁰, Manesh Kumar Gangwani, MD¹¹, Douglas Adler, MD¹². P0214 - Colonoscopy Within 3 Weeks May Reduce Mortality and Complications in Lower Gastrointestinal Bleeding: A Multicenter Retrospective Analysis, ACG 2024 Annual Scientific Meeting Abstracts. Philadelphia, PA: American College of Gastroenterology.