Factors That Contribute to Blood Loss in Patients With Colonic Angiodysplasia From a Population-Based Study

Naomi G. Diggs, Jennifer L. Holub, David A. Lieberman, Glenn M. Eisen, Lisa L. Strate

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Background & Aims: Most studies of angiodysplasia are small and performed at a single center. We investigated the epidemiology and management of colonic angiodysplasia by using a national endoscopy database. Methods: Colonoscopy reports (n = 229,727; generated from January 2000 to December 2002) from patients with documented angiodysplasia (n = 4159) were retrieved from the Clinical Outcomes Research Initiative. Predictors of occult or overt blood loss and endoscopic treatment were identified by using multivariate logistic regression. Results: Most patients with documented angiodysplasia were older than 60 years (73%) or had right-sided lesions (62%). There was evidence of blood loss in 56% of patients with angiodysplasia. Predictors of blood loss included inpatient status (odds ratio [OR], 8.74; 95% confidence interval [CI], 5.42-14.10), 2-10 angiodysplasias (OR, 1.50; 95% CI, 1.29-1.75), more than 10 lesions (OR, 2.18; 95% CI, 1.69-2.80), black race (OR, 1.95; 95% CI, 1.46-2.62), severe illness (OR, 1.97; 95% CI, 1.62-2.41), Hispanic ethnicity (OR, 1.71; 95% CI, 1.32-2.22), and age older than 80 years (OR, 1.32; 95% CI, 1.06-1.63). Endoscopic therapy was given to 28% of patients with evidence of blood loss and in 68% with active bleeding. Endoscopic treatment increased among patients in a university practice setting (vs community setting, OR, 2.53; 95% CI, 1.96-3.27) and decreased in Northwest geographic locations (vs Southwest, OR, 0.60; 95% CI, 0.43-0.84). Conclusions: Predictors of blood loss in patients with colonic angiodysplasia include inpatient status, comorbidities, age, race/ethnicity, and lesion number. Endoscopic therapy for angiodysplasia varied according to practice setting and region.

Original languageEnglish (US)
Pages (from-to)415-420
Number of pages6
JournalClinical Gastroenterology and Hepatology
Volume9
Issue number5
DOIs
StatePublished - May 1 2011

Keywords

  • CORI
  • Lower Gastrointestinal Bleeding
  • Practice Patterns

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

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