title: The Clinical Outcomes of Lower Gastrointestinal Bleeding Are Not Better than Those of Upper Gastrointestinal Bleeding.
abstract: The incidence of lower gastrointestinal bleeding (LGIB) is increasing; however, predictors of outcomes for patients with LGIB are not as well defined as those for patients with upper gastrointestinal bleeding (UGIB). The aim of this study was to identify the clinical outcomes and the predictors of poor outcomes for patients with LGIB, compared to outcomes for patients with UGIB. We identified patients with LGIB or UGIB who underwent endoscopic procedures between July 2006 and February 2013. Propensity score matching was used to improve comparability between LGIB and UGIB groups. The clinical outcomes and predictors of 30-day rebleeding and mortality rate were analyzed between the two groups. In total, 601 patients with UGIB (n = 500) or LGIB (n = 101) were included in the study, and 202 patients with UGIB and 101 patients with LGIB were analyzed after 2:1 propensity score matching. The 30-day rebleeding and mortality rates were 9.9% and 4.5% for the UGIB group, and 16.8% and 5.0% for LGIB group, respectively. After logistic regression analysis, the Rockall score (P = 0.013) and C-reactive protein (CRP; P = 0.047) levels were significant predictors of 30-day mortality in patients with LGIB; however, we could not identify any predictors of rebleeding in patients with LGIB. The clinical outcomes for patients with LGIB are not better than clinical outcomes for patients with UGIB. The clinical Rockall score and serum CRP levels may be used to predict 30-day mortality in patients with LGIB.
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Min Seob
authors.identifier: http://orcid.org/0000-0002-8988-7423
authors.initials: MS
authors.lastname: Kwak
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea. drcha@khu.ac.kr.
authors.forename: Jae Myung
authors.identifier: http://orcid.org/0000-0001-9403-230X
authors.initials: JM
authors.lastname: Cha
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Yong Jae
authors.identifier: http://orcid.org/0000-0003-0647-578X
authors.initials: YJ
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Jin Young
authors.identifier: http://orcid.org/0000-0002-2761-0891
authors.initials: JY
authors.lastname: Yoon
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Jung Won
authors.identifier: http://orcid.org/0000-0002-5493-5843
authors.initials: JW
authors.lastname: Jeon
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Hyun Phil
authors.identifier: http://orcid.org/0000-0002-6074-6045
authors.initials: HP
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Kwang Ro
authors.identifier: http://orcid.org/0000-0002-7887-9006
authors.initials: KR
authors.lastname: Joo
authors.affiliation: Department of Internal Medicine, Kyung Hee University Hospital at Gangdong, Kyung Hee University School of Medicine, Seoul, Korea.
authors.forename: Joung Il
authors.identifier: http://orcid.org/0000-0002-0142-1398
authors.initials: JI
authors.lastname: Lee
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D016145:Endoscopy, Digestive System; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000401:mortality / Q000473:pathology*; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D057216:Propensity Score; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate
chemical_list: D002097:C-Reactive Protein
keywords: Colonoscopy; Gastrointestinal Bleeding; Hematochezia; Mortality; Prognosis