Early feeding reduces length of hospital stay in patients with acute lower gastrointestinal bleeding: A large multicentre cohort study

被引：1

作者：

Kishino, Takaaki ^{[1
]}

Aoki, Tomonori ^{[2
]}

Sadashima, Eiji ^{[3
]}

Kobayashi, Katsumasa ^{[4
]}

Yamauchi, Atsushi ^{[5
]}

Yamada, Atsuo ^{[2
]}

Omori, Jun ^{[6
]}

Ikeya, Takashi ^{[7
]}

Aoyama, Taiki ^{[8
]}

Tominaga, Naoyuki ^{[9
]}

Sato, Yoshinori ^{[10
]}

Ishii, Naoki ^{[11
]}

Sawada, Tsunaki ^{[12
]}

Murata, Masaki ^{[13
]}

Takao, Akinari ^{[14
]}

Mizukami, Kazuhiro ^{[15
]}

Kinjo, Ken ^{[16
]}

Fujimori, Shunji ^{[17
]}

Uotani, Takahiro ^{[18
]}

Fujita, Minoru ^{[19
]}

Sato, Hiroki ^{[20
]}

Suzuki, Sho ^{[21
,22
]}

Narasaka, Toshiaki ^{[23
]}

Hayasaka, Junnosuke ^{[24
]}

Funabiki, Tomohiro ^{[25
]}

Kinjo, Yuzuru ^{[26
]}

Mizuki, Akira ^{[27
]}

Kiyotoki, Shu ^{[28
]}

Mikami, Tatsuya ^{[29
]}

Gushima, Ryosuke ^{[30
]}

Fujii, Hiroyuki ^{[31
]}

Fuyuno, Yuta ^{[32
]}

Gunji, Naohiko ^{[33
]}

Toya, Yosuke ^{[34
]}

Narimatsu, Kazuyuki ^{[35
]}

Manabe, Noriaki ^{[36
]}

Nagaike, Koji ^{[37
]}

Kinjo, Tetsu ^{[38
]}

Sumida, Yorinobu ^{[39
]}

Funakoshi, Sadahiro ^{[40
]}

Kobayashi, Kiyonori ^{[41
]}

Matsuhashi, Tamotsu ^{[42
]}

Komaki, Yuga ^{[43
]}

Kaise, Mitsuru ^{[6
]}

Nagata, Naoyoshi ^{[44
,45
]}

机构：

[1] Nara City Hosp, Ctr Digest & Liver Dis, Dept Gastroenterol & Hepatol, Nara, Japan

[2] Univ Tokyo, Grad Sch Med, Dept Gastroenterol, Tokyo, Japan

[3] Saga Ken Med Ctr Koseikan, Dept Cardiovasc Med, Saga, Japan

[4] Tokyo Metropolitan Bokutoh Hosp, Dept Gastroenterol, Tokyo, Japan

[5] Kitano Hosp, Tazuke Kofukai Med Res Inst, Dept Gastroenterol & Hepatol, Osaka, Japan

[6] Nippon Med Sch, Grad Sch Med, Dept Gastroenterol, Tokyo, Japan

[7] St Lukes Int Univ, Dept Gastroenterol, Tokyo, Japan

[8] Hiroshima City Asa Citizens Hosp, Dept Gastroenterol, Hiroshima, Japan

[9] Saga Med Ctr Koseikan, Dept Gastroenterol, Saga, Japan

[10] St Marianna Univ, Sch Med, Div Gastroenterol & Hepatol, Dept Internal Med, Yokohama, Kanagawa, Japan

[11] Tokyo Shinagawa Hosp, Dept Gastroenterol, Tokyo, Japan

[12] Nagoya Univ Hosp, Dept Endoscopy, Nagoya, Aichi, Japan

[13] Natl Hosp Org Kyoto Med Ctr, Dept Gastroenterol, Kyoto, Japan

[14] Komagome Hosp, Tokyo Metropolitan Canc & Infect Dis Ctr, Dept Gastroenterol, Tokyo, Japan

[15] Oita Univ, Dept Gastroenterol, Oita, Japan

[16] Fukuoka Univ, Chikushi Hosp, Dept Gastroenterol, Fukuoka, Japan

[17] Nippon Med Sch, Chiba Hokusoh Hosp, Dept Gastroenterol, Chiba, Japan

[18] Japanese Red Cross Shizuoka Hosp, Dept Gastroenterol, Shizuoka, Japan

[19] Kawasaki Med Sch, Gen Med Ctr, Div Endoscopy & Ultrasonog, Dept Clin Pathol & Lab Med, Okayama, Japan

[20] Niigata Univ, Grad Sch Med & Dent Sci, Div Gastroenterol, Niigata, Japan

[21] Univ Miyazaki Hosp, Ctr Digest Dis, Dept Gastroenterol & Hepatol, Miyazaki, Japan

[22] Univ Miyazaki Hosp, Div Endoscopy, Miyazaki, Japan

[23] Univ Tsukuba, Dept Gastroenterol, Ibaraki, Japan

[24] Toranomon Gen Hosp, Dept Gastroenterol, Tokyo, Japan

[25] Saiseikai Yokohamashi Tobu Hosp, Emergency & Crit Care Ctr, Yokohama, Kanagawa, Japan

[26] Naha City Hosp, Dept Gastroenterol, Naha, Okinawa, Japan

[27] Tokyo Saiseikai Cent Hosp, Dept Internal Med, Tokyo, Japan

[28] Shuto Gen Hosp, Dept Gastroenterol, Yamaguchi, Japan

[29] Hirosaki Univ Hosp, Div Endoscopy, Aomori, Japan

[30] Kumamoto Univ, Grad Sch Med Sci, Dept Gastroenterol & Hepatol, Kumamoto, Japan

[31] Natl Hosp Org Fukuokahigashi Med Ctr, Dept Gastroenterol & Hepatol, Fukuoka, Japan

[32] Kyushu Univ, Grad Sch Med Sci, Dept Med & Clin Sci, Fukuoka, Japan

[33] Fukushima Med Univ, Dept Gastroenterol, Fukushima, Japan

[34] Iwate Med Univ, Dept Internal Med, Div Gastroenterol, Morioka, Iwate, Japan

[35] Natl Def Med Coll, Dept Internal Med, Saitama, Japan

[36] Kawasaki Med Sch, Dept Clin Pathol & Lab Med, Div Endoscopy & Ultrasonog, Okayama, Japan

[37] Suita Municipal Hosp, Dept Gastroenterol & Hepatol, Osaka, Japan

[38] Univ Ryukyus Hosp, Dept Endoscopy, Nishihara, Okinawa, Japan

[39] Natl Hosp Org Kyushu Med Ctr, Dept Gastroenterol, Fukuoka, Japan

[40] Fukuoka Univ Hosp, Dept Gastroenterol Endoscopy, Fukuoka, Japan

[41] Kitasato Univ, Sch Med, Dept Gastroenterol, Sagamihara, Kanagawa, Japan

[42] Akita Univ, Grad Sch Med, Dept Gastroenterol & Neurol, Akita, Japan

[43] Kagoshima Univ, Grad Sch Med & Dent Sci, Digest & Lifestyle Dis, Kagoshima, Japan

[44] Tokyo Med Univ, Dept Gastroenterol Endoscopy, Tokyo, Japan

[45] Natl Ctr Global Hlth & Med, Dept Gastroenterol & Hepatol, Tokyo, Japan

来源：

COLORECTAL DISEASE | 2023年 / 25卷 / 11期

关键词：

acute lower gastrointestinal bleeding; colonic diverticular haemorrhage; delayed feeding; early feeding; fasting; length of hospital stay; ELECTIVE COLORECTAL SURGERY; RISK; TRIAL; VALIDATION; MANAGEMENT; GUIDELINE; LIGATION; SOCIETY; SCORE; SAFE;

D O I：

10.1111/codi.16751

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Aim: No studies have compared the clinical outcomes of early and delayed feeding in patients with acute lower gastrointestinal bleeding (ALGIB). This study aimed to evaluate the benefits and risks of early feeding in a nationwide cohort of patients with ALGIB in whom haemostasis was achieved. Methods: We reviewed data for 5910 patients with ALGIB in whom haemostasis was achieved and feeding was resumed within 3 days after colonoscopy at 49 hospitals across Japan (CODE BLUE-J Study). Patients were divided into an early feeding group (<= 1 day, n = 3324) and a delayed feeding group (2-3 days, n = 2586). Clinical outcomes were compared between the groups by propensity matching analysis of 1508 pairs. Results: There was no significant difference between the early and delayed feeding groups in the rebleeding rate within 7 days after colonoscopy (9.4% vs. 8.0%; p = 0.196) or in the rebleeding rate within 30 days (11.4% vs. 11.5%; p = 0.909). There was also no significant between-group difference in the need for interventional radiology or surgery or in mortality. However, the median length of hospital stay after colonoscopy was significantly shorter in the early feeding group (5 vs. 7 days; p < 0.001). These results were unchanged when subgroups of presumptive and definitive colonic diverticular bleeding were compared. Conclusion: The findings of this nationwide study suggest that early feeding after haemostasis can shorten the hospital stay in patients with ALGIB without increasing the risk of rebleeding.

引用

页码：2206 / 2216

页数：11

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