Endoscopy 2020; 52(S 01): S279
DOI: 10.1055/s-0040-1704883
ESGE Days 2020 ePoster presentations
Colon and rectum 09:00–17:00 Thursday, April 23, 2020 ePoster area
© Georg Thieme Verlag KG Stuttgart · New York

ACUTE LOWER GASTROINTESTINAL BLEEDING IN ITALY (ALIBI STUDY): A MULTICENTRE PROSPECTIVE, COHORT STUDY

A Andrealli
1   Ospedale Valduce, Como, Italy
,
F Radaelli
1   Ospedale Valduce, Como, Italy
,
L Frazzoni
2   Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
,
A Repici
3   Istituto Clinico Humanitas, Humanitas Research Hospital, Rozzano, Milano, Italy
,
A Mussetto
4   Gastroenterology Unit, S. Maria delle Croci Hospital, Ravenna, Italy
,
C Spada
5   Digestive Endoscopy Unit, Fondazione Poliambulanza, Brescia, Italy
,
G Manes
6   Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milano, Italy
,
S Segato
7   Ospedale di Circolo e Fondazione Macchi, Varese, Italy
,
A Musso
8   Città della Salute e della Scienza, Presidio Le Molinette, Torino, Italy
,
E Di Giulio
9   Azienda Ospedaliera Sant’Andrea, Roma, Italy
,
M Manno
10   UOSD Gastroenterologia ed Endoscopia Digestiva, Azienda USL di Modena, Carpi, Italy
,
G De Nucci
6   Department of Gastroenterology, ASST Rhodense, Rho and Garbagnate Milanese Hospital, Milano, Italy
,
V Festa
11   ASL Roma 1, Ospedale San Filippo Neri, Roma, Italy
,
A Di Leo
12   UO Gastroenterologia Policlinico di Bari, Bari, Italy
,
M Marini
13   Azienda Ospedaliera Universitaria Senese, Siena, Italy
,
L Ferraris
14   ASST Valle Olona, Presidio Ospedaliero di Gallarate, Varese, Italy
,
C Hassan
15   Endoscopy Unit, Nuovo Regina Margherita Hospital, Roma, Italy
,
L Fuccio
2   Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy
,
S Paggi
1   Ospedale Valduce, Como, Italy
› Author Affiliations
Further Information

Publication History

Publication Date:
23 April 2020 (online)

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    Aims Acute lower GI bleeding (LGIB) is an increasing indication for hospitalization. However, data on clinical presentation, management and outcomes are limited. This Italian, multicentre, prospective observational study was designed to explore these areas.

    Methods The study was conducted from October 1st 2018 to October 28th 2019 in 15 hospitals. Consecutive, unselected adult with acute LGIB were included.

    Results Data on 1198 cases (1060 new admissions;138 inpatients) were analysed. Mean age was 74 ± 15 years and 76% had ≥ 1 major comorbidity; 31.6% were on antiplatelet agents, 26.7% on anticoagulants. At presentation, 356 (29.7%) patients underwent esophagogastroduodenoscopy that ruled out an upper GI bleeding. Colonoscopy and sigmoidoscopy were the primary investigations in most patients (736/1198, 61.4%), with therapeutic interventions in 208 (17.3%). Abdominal CT/US and CT-angiography represented the first diagnostic step in 281 (23.4%) and 62 (5.2%) cases, respectively. Overall, 523 (43.6%) patients required at least one further examination, this figure being significantly lower in patients undergoing colonoscopy first (29.5% vs. 67.8%, p < 0.001). As a whole, 998 (83.3%) patients underwent lower GI endoscopy, 83(6.9%) CT-angiography, 20 (1.6%) mesenteric angiography (8 with embolization), 32 (2.7%) videocapsule endoscopy; 117 (9.8%) patients did not undergo any inpatient investigation. A definite or presumptive source of bleeding was disclosed in 977/1081 (90.4%); diverticular bleeding was the most common diagnosis. Small bowel bleeding was found in 41 (3.8%) cases. RBC transfusions were administered in 526 (43.9%) patients, mostly following a non-restrictive strategy. The median (IQR) length of stay was 7 (5–12) days. In-hospital rebleeding and mortality were reported in 105 (9.7%) and 41 (3.4%) patients, respectively, both these figures being significantly higher for inpatients than outpatients (6%vs.2.7%, p < 0.001; 8%vs.14.5%, p = 0.01, respectively).

    Conclusions This is the first Italian prospective study on LGIB. Patients with LGIB are elderly, have multiple comorbidities and frequent antithrombotic use. Their management varies across centres and might benefit from a better standardization. In-hospital mortality is comparable to UGIB.


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