Adverse Events during Bowel Preparation and Colonoscopy in Patients with Acute Lower Gastrointestinal Bleeding Compared with Elective Non-Gastrointestinal Bleeding

作者：Niikura Ryota; Nagata Naoyoshi^*; Shimbo Takuro; Sakurai Toshiyuki; Aoki Tomonori; Moriyasu Shiori; Sekine Katsunori; Okubo Hidetaka; Watanabe Kazuhiro; Yokoi Chizu; Yamada Atsuo; Hirata Yoshihiro; Koike Kazuhiko; Akiyama Junichi; Uemura Naomi

来源：PLos One, 2015, 10(9): e0138000.

DOI：10.1371/journal.pone.0138000

Background
There are limited data on the safety of colonoscopy in patients with lower gastrointestinal bleeding (LGIB). We examined the various adverse events associated with colonoscopy in acute LGIB compared with non-GIB patients.
Methods
Emergency hospitalized LGIB patients (n = 161) and age-and gender-matched non-GIB controls (n = 161) were selected. Primary outcomes were any adverse events during preparation and colonoscopy procedure. Secondary outcomes were five bowel preparationrelated adverse events-hypotension, systolic blood pressure < 100 mmHg, volume overload, vomiting, aspiration pneumonia and loss of consciousness-and four colonoscopyrelated adverse events-including hypotension, perforation, cerebrocardiovascular events and sepsis.
Results
During bowel preparation, 16 (9%) LGIB patients experienced an adverse event. None of the LGIB patients experienced volume overload, aspiration pneumonia or loss of consciousness; however, 12 (7%) had hypotension and 4 (2%) vomited. There were no significant differences in the five bowel preparation-related adverse events between LGIB and non-GIB patients. During colonoscopy, 25 (15%) LGIB patients experienced an adverse event. None LGIB patient had perforation or sepsis; however, 23 (14%) had hypotension and 2 (1%) experienced a cerebrocardiovascular event. There was no significant difference in the four colonoscopy-related adverse events between LGIB and non-GIB patients. In addition, no significant difference in any of the nine adverse events was found among subgroups: patients aged >= 65 years, those with comorbidities, and those with antithrombotic drug use.
Conclusions
Adverse events in bowel preparation and colonoscopy among acute LGIB patients were low. No significant difference was found in adverse events between LGIB and non-GIB patients. These adverse events were also low in elderly LGIB patients, as well as in those with co-morbidities and antithrombotic drug use, suggesting that colonoscopy performed during acute LGIB did not increase adverse events.

• 出版日期2015-9-14