Clinical characteristics, interventions and outcomes of acute lower gastrointestinal bleeding: A multicenter study in Vietnam

Original Research

Abstract

Introduction: Despite many medical advances, acute lower gastrointestinal bleeding in Asia has been increasing gradually and has resulted in substantial mortality. The study aimed to describe the clinical characteristics, interventions, and outcomes of acute lower gastrointestinal bleeding in Vietnamese people.

Methods: A multicenter cohort study was prospectively and retrospectively conducted in patients presenting with acute lower gastrointestinal bleeding in Vietnam. Severe lower gastrointestinal bleeding was defined as persistent bleeding within the first 24 hours and/or recurrent bleeding after 24 hours of stability accompanied by a reduction in hematocrit of ≥ 20% and/or transfusion of ≥ 2 units of red blood cells. The clinical characteristics, interventions, and adverse outcomes were recorded.

Results: There were 811 patients with a male: female ratio of 1.07 and a mean age of 61 years. A total of 85.6% of patients presented with hematochezia. The common causes of acute lower gastrointestinal bleeding were hemorrhoids (28.6%), diverticulosis (9.7%), and unknown origin (16%). The rates of blood transfusion, endoscopic therapy, radiologic intervention, and surgery were 39.8%, 8.6%, 0.5%, and 7.3%, respectively. Severe lower gastrointestinal bleeding was observed in 222 (27.4%) patients. In-hospital deaths were recorded in 17 (2.1%) patients. The majority of in-hospital deaths were due to unstable comorbidities.

Conclusions: Hemorrhoids were the most common cause of acute lower gastrointestinal bleeding. The rates of blood transfusion, endoscopic hemostasis, interventional radiology, and surgery were 39.8%, 8.6%, 0.5%, and 7.3%, respectively. A total of 27.4% of cases progressed to severe bleeding. 

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