Clinical Endoscopy

Reviews

The potential for social implementation of colorectal cancer screening by colonoscopy: Fumiaki Ishibashi, Masau Sekiguchi, Sho Suzuki; Received August 5, 2025 Accepted October 14, 2025 Published online December 23, 2025; DOI: https://doi.org/10.5946/ce.2025.259 [Epub ahead of print]

Abstract PDF PubReader ePub: The incidence of colorectal cancer (CRC) is increasing worldwide, which poses substantial social and economic challenges. To reduce CRC-related mortality, the implementation of screening programs is essential. The current standard approach involves initial screening using the fecal immunochemical test (FIT), followed by colonoscopy. However, the FIT has inherent limitations, including the potential to miss early stage CRC and insufficient detection rates from a single test. Therefore, the FIT is repeated annually or biennially, and the incidence of interval cancer remains a concern. In contrast, colonoscopy allows a highly accurate diagnosis of CRC in a single examination. Of the five randomized controlled trials evaluating the impact of colonoscopy on CRC mortality, two have reported results to date. The mortality reduction effect of colonoscopy-based screening was somewhat lower than expected in these studies, primarily because of low participation rates. Nonetheless, the fact that countries such as the United States and Germany, which have already implemented colonoscopy-based screening, have experienced substantial reductions in CRC mortality, which supports the expectations of the effectiveness of implementing such programs at the societal level. Among the challenges in their implementation, ensuring adequate participation rates is essential, and the establishment of an organized screening system is warranted.

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Non-variceal upper gastrointestinal bleeding: advances and future directions in management: Waku Hatta, Yohei Ogata, Takashi Chiba, Naotaro Tanno, Makoto Kawabe, Kimiko Kayada, Yutaka Hatayama, Masahiro Saito, Akira Imatani, Tomoyuki Koike, Atsushi Masamune; Received June 26, 2025 Accepted September 21, 2025 Published online December 17, 2025; DOI: https://doi.org/10.5946/ce.2025.202 [Epub ahead of print]

Abstract PDF PubReader ePub: Numerous clinical guidelines have been developed for the management of non-variceal upper gastrointestinal bleeding (NVUGIB), yet significant variations exist among the recommendations. This review summarizes the most recent evidence on NVUGIB management, structured across four key stages: pre-endoscopic management, endoscopic treatment, post-endoscopic care, and the identification and management of refractory bleeding. In the pre-endoscopic phase, several risk-scoring systems have been developed to predict mortality. A restrictive transfusion strategy, with a threshold of 7 to 8 g/dL, is now recommended for most patients. Pre-endoscopic administration of intravenous erythromycin also improves visualization during endoscopy. A wide array of endoscopic hemostasis techniques is available, with the choice of method depending on the underlying cause of bleeding. When endoscopic hemostasis fails, transcatheter arterial embolization (TAE) is generally preferred over surgery as the second-line intervention. Once hemostasis is achieved, high-dose acid suppression is essential, and the risk of rebleeding should be assessed. For patients who experience rebleeding, repeat endoscopic therapy is recommended as the first-line approach. However, determining the optimal timing for TAE remains a challenge. Because of the heterogeneity of clinical presentations, NVUGIB management should be personalized. Further research is needed to establish evidence-based, individualized treatment strategies.

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Original Articles

Influence of sarcopenia on clinical outcomes in peptic ulcer bleeding: a retrospective single-center analysis in Korea: Ji Hoon Yu, Hyun Tak Lee, Seok Ki Jang, Ah Young Lee, Jun-young Seo; Clin Endosc 2025;58(3):425-437. Published online January 21, 2025; DOI: https://doi.org/10.5946/ce.2024.209

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Background
/Aims: Peptic ulcer bleeding (PUB) is a major cause of nonvariceal gastrointestinal bleeding. As the older population increases, the prevalence of sarcopenia is also growing. Although sarcopenia influences the prognosis of various diseases, its association with clinical outcomes of PUB remains unknown. Therefore, this study aimed to explore this correlation.
Methods
We retrospectively analyzed 2,050 patients who underwent esophagogastroduodenoscopy for suspected gastrointestinal bleeding between January 2014 and December 2021. Patients who underwent computed tomography scans were included for sarcopenia evaluation based on the psoas muscle index, defined as the total psoas area normalized by the square of the height of the patient. Sarcopenia was defined using specific cutoffs: ≤7.3 cm2/m2 and ≤5.1 cm2/m2 for men and women, respectively. The primary outcome measured was the 30-day mortality rate.
Results
Out of 358 patients, 149 were diagnosed with sarcopenia. The 30-day mortality rate was significantly higher in patients with sarcopenia than in those without. Multivariate regression analysis revealed significant associations between sarcopenia, a high age, blood tests, and comorbidity score, and administration of inotropic agents with 30-day mortality.
Conclusions
Our study showed that the presence of sarcopenia, elevated comorbidity scores, and use of inotropes were associated with higher 30-day mortality rates. Considering that sarcopenia may influence the clinical outcomes in patients with PUB, it is crucial to manage patients with sarcopenia with particular care.

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Sarcopenia, under-recognized yet clinically significant aspect of gastrointestinal emergencies
Ji Young Chang
Clinical Endoscopy.2026; 59(1): 158. CrossRef
Sarcopenia in the era of aging populations: its clinical implications for peptic ulcer bleeding
Hiroyuki Hisada, Yosuke Tsuji, Mitsuhiro Fujishiro
Clinical Endoscopy.2025; 58(3): 401. CrossRef

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Endoscopic versus surgical management for colonic volvulus hospitalizations in the United States: Dushyant Singh Dahiya, Abhilash Perisetti, Hemant Goyal, Sumant Inamdar, Amandeep Singh, Rajat Garg, Chin-I Cheng, Mohammad Al-Haddad, Madhusudhan R. Sanaka, Neil Sharma; Clin Endosc 2023;56(3):340-352. Published online April 17, 2023; DOI: https://doi.org/10.5946/ce.2022.166

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Background
/Aims: Colonic volvulus (CV), a common cause of bowel obstruction, often requires intervention. We aimed to identify hospitalization trends and CV outcomes in the United States.
Methods
We used the National Inpatient Sample to identify all adult CV hospitalizations in the United States from 2007 to 2017. Patient demographics, comorbidities, and inpatient outcomes were highlighted. Outcomes of endoscopic and surgical management were compared.
Results
From 2007 to 2017, there were 220,666 CV hospitalizations. CV-related hospitalizations increased from 17,888 in 2007 to 21,715 in 2017 (p=0.001). However, inpatient mortality decreased from 7.6% in 2007 to 6.2% in 2017 (p<0.001). Of all CV-related hospitalizations, 13,745 underwent endoscopic intervention, and 77,157 underwent surgery. Although the endoscopic cohort had patients with a higher Charlson comorbidity index, we noted lower inpatient mortality (6.1% vs. 7.0%, p<0.001), mean length of stay (8.3 vs. 11.8 days, p<0.001), and mean total healthcare charge ($68,126 vs. $106,703, p<0.001) compared to the surgical cohort. Male sex, increased Charlson comorbidity index scores, acute kidney injury, and malnutrition were associated with higher odds of inpatient mortality in patients with CV who underwent endoscopic management.
Conclusions
Endoscopic intervention has lower inpatient mortality and is an excellent alternative to surgery for appropriately selected CV hospitalizations.

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Safety and Efficacy of Endoscopic Derotation in Colonic Volvulus Occlusion: Systematic Review and Meta-Analysis
Filippo Sabatini, Luca Properzi, Gabriele Marinozzi, Gabrio Bassotti, Bruno Cirillo, Gioia Brachini, Francesco Brucchi, Sara Lauricella, Alberto Santoro, Matteo Matteucci, Antonia Rizzuto, Roberto Cirocchi
Journal of Clinical Medicine.2026; 15(3): 1190. CrossRef
Medical disputes involving lower gastrointestinal endoscopies: cases from the Korean Medical Dispute Mediation and Arbitration Agency
Eun Hye Oh, Jeong Eun Shin, Jun Yong Bae, Yoon Suk Lee, Yehyun Park, Yong Hwan Kwon, Chang Nyol Paik, Jun Kyu Lee, Tae Hee Lee
The Korean Journal of Internal Medicine.2025; 40(3): 404. CrossRef
Colonic Volvulus
Samantha L. Savitch, Calista M. Harbaugh
Clinics in Colon and Rectal Surgery.2024; 37(06): 398. CrossRef
Navigating Abdominal Volvulus: A Comprehensive Review of Management Strategies
Simran Chauhan, Raju K Shinde, Yashraj Jain
Cureus.2024;[Epub] CrossRef
Clinicopathological Features of Elderly Patients with Colonic Volvulus
Mehmet Onur Gul, Selda Oğuz Aşlayan, Kadir Çorbacı, Aytaç Selman, Emre Berat Akçay, Oğuzhan Sunamak, Cebrail Akyüz
European Journal of Therapeutics.2024; 30(3): 303. CrossRef
Hospitalizaciones por vólvulo en Chile: caracterización de la tasa de egreso hospitalario durante el período 2019-2022.
Ignacio González Soto, Vicente Villegas Rivera, Monserrat Ruiz Ruiz, Osvaldo Herrera Riffo, Javiera Yanccoli Torres, B Mena
Revista ANACEM.2024; 18(1): 64. CrossRef
Incidental Sigmoid Volvulus after a Ground-level Fall: An Unusual Case Report
Ziya Karimov, Elchin Shirinov, Gunay Huseynova, Mirhuseyn Mammadov, Meltem Songür Kodik
Caucasian Medical Journal.2023; 1(3): 36. CrossRef

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Risk Stratification in Cancer Patients with Acute Upper Gastrointestinal Bleeding: Comparison of Glasgow-Blatchford, Rockall and AIMS65, and Development of a New Scoring System: Matheus Cavalcante Franco, Sunguk Jang, Bruno da Costa Martins, Tyler Stevens, Vipul Jairath, Rocio Lopez, John J. Vargo, Alan Barkun, Fauze Maluf-Filho; Clin Endosc 2022;55(2):240-247. Published online January 21, 2022; DOI: https://doi.org/10.5946/ce.2021.115

Abstract PDF PubReader ePub

Background
/Aims: Few studies have measured the accuracy of prognostic scores for upper gastrointestinal bleeding (UGIB) among cancer patients. Thereby, we compared the prognostic scores for predicting major outcomes in cancer patients with UGIB. Secondarily, we developed a new model to detect patients who might require hemostatic care.
Methods
A prospective research was performed in a tertiary hospital by enrolling cancer patients admitted with UGIB. Clinical and endoscopic findings were obtained through a prospective database. Multiple logistic regression analysis was performed to gauge the power of each score.
Results
From April 2015 to May 2016, 243 patients met the inclusion criteria. The AIMS65 (area under the curve [AUC] 0.85) best predicted intensive care unit admission, while the Glasgow-Blatchford score best predicted blood transfusion (AUC 0.82) and the low-risk group (AUC 0.92). All scores failed to predict hemostatic therapy and rebleeding. The new score was superior (AUC 0.74) in predicting hemostatic therapy. The AIMS65 (AUC 0.84) best predicted in-hospital mortality.
Conclusions
The scoring systems for prognostication were validated in the group of cancer patients with UGIB. A new score was developed to predict hemostatic therapy. Following this result, future prospective research should be performed to validate the new score.

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A unified prognostic tool for predicting critical outcomes in gastrointestinal bleeding
Seyyed Mahdi Zia Ziabari, Nazanin Noori Roodsari, Afshin Shafaghi, Seyyed Hassan Miri, Mohammadali Yazdanipour, Negin Letafatkar, Arman Habibi, Amirreza Aflak, Fatemeh Mohammadyari
Medicine.2026; 105(9): e47835. CrossRef
Comparative diagnostic utility of Rockall and Glasgow-Blatchford scores in non-variceal upper gastrointestinal bleeding: a systematic review and meta-analysis
Landon Kozai, Arvin Tan, Kevin Nebrejas, Yoshito Nishimura
European Journal of Gastroenterology & Hepatology.2025; 37(2): 161. CrossRef
Risk stratification and scoring systems in upper and lower gastrointestinal bleeding: review of performance and limitations in the emergency department
Fatemeh Mohammadyari, Amirreza Aflak, Mahta ZareDini, Reza Irandoost, Saeed Ghaffari, Arsham Gharib, Minaalsadat Roshanaei, Mazyar Tahavori, Sepehr Olangian-Tehrani
Frontiers in Medicine.2025;[Epub] CrossRef
Are Scoring Systems Useful in Predicting Mortality from Upper GI Bleeding in Geriatric Patients?
Mustafa Zanyar Akkuzu, Berat Ebik
Diagnostics.2025; 15(17): 2173. CrossRef
Endoscopic Management of Tumor Bleeding
Frances Dang, Marc Monachese
Gastrointestinal Endoscopy Clinics of North America.2024; 34(1): 155. CrossRef
Clinical significance of D-dimer, antithrombin III, and Helicobacter pylori infection in acute upper gastrointestinal bleeding
Cong-Biao Cheng, Na Li
World Chinese Journal of Digestology.2024; 32(7): 501. CrossRef
The Accuracy of Pre-Endoscopic Scores for Mortality Prediction in Patients with Upper GI Bleeding and No Endoscopy Performed
Sergiu Marian Cazacu, Dragoș Ovidiu Alexandru, Răzvan-Cristian Statie, Sevastița Iordache, Bogdan Silviu Ungureanu, Vlad Florin Iovănescu, Petrică Popa, Victor Mihai Sacerdoțianu, Carmen Daniela Neagoe, Mirela Marinela Florescu
Diagnostics.2023; 13(6): 1188. CrossRef
Progress in the Evaluation of Acute Upper Gastrointestinal Bleeding with AIMS65 Scoring System
莉王
Advances in Clinical Medicine.2023; 13(05): 8163. CrossRef
Interpretations of the Role of Plasma Albumin in Prognostic Indices: A Literature Review
Kim Oren Gradel
Journal of Clinical Medicine.2023; 12(19): 6132. CrossRef

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Acute Gastrointestinal Bleeding in COVID-19 Patients: A Systematic Review and Meta-Analysis: Umair Iqbal, Hafsa Anwar, Hafiz Umair Siddiqui, Muhammad Ali Khan, Faisal Kamal, Bradley D. Confer, Harshit S. Khara; Clin Endosc 2021;54(4):534-541. Published online June 25, 2021; DOI: https://doi.org/10.5946/ce.2021.071

Abstract PDF Supplementary Material PubReader ePub

Background
/Aims: More than 100 million people to date have been affected by the coronavirus disease-2019 (COVID-19) pandemic. Patients with COVID-19 have a higher risk of bleeding complications. We performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 patients with signs and symptoms of acute gastrointestinal bleeding (GIB).
Methods
A systematic literature search was carried out for articles published until until November 11, 2020, in the Embase, MEDLINE, Web of Science, and Cochrane Library databases. We included studies on COVID-19 patients with signs and symptoms of GIB.
Results
Our search yielded 49 studies, of which eight with a collective 127 patients (86 males and 41 females) met our inclusion criteria. Conservative management alone was performed in 59% of the patients, endoscopic evaluation in 31.5%, and interventional radiology (IR) embolization in 11%. Peptic ulcer disease was the most common endoscopic finding, diagnosed in 47.5% of the patients. Pooled overall mortality was 19.1% (95% confidence interval [CI]; 12.7%-27.6%) and pooled mortality secondary to GIB was 3.5% (95% CI; 1.3%–9.1%). The pooled risk of rebleeding was 11.3% (95% CI; 6.8%–18.4%).
Conclusions
The majority of COVID-19 patients with GIB responded to conservative management, with a low mortality rate associated with GIB and the risk of rebleeding. Thus, we suggest limiting endoscopic and IR interventions to those with hemodynamic instability and those for whom conservative management was unsuccessful.

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Incidence and Outcomes of Upper GI Bleeding in Hospitalized SARS‐CoV‐2 Patients
Erin Sanzone, Katherine Gheysens, Krystal Hunter, Adib Chaaya, Sangita Phadtare, Tatsuya Toyokawa
Gastroenterology Research and Practice.2025;[Epub] CrossRef
Increased Overall Mortality in Patients Admitted for Gastrointestinal Bleeding and COVID-19 Infection Compared to No COVID-19 Infection: A Systematic Review and Meta-Analysis
Sergiu Marian Cazacu, Adina Turcu-Stiolica, Cristina Maria Marginean, Ion Rogoveanu
Gastroenterology Insights.2025; 16(3): 20. CrossRef
Prevalence and outcomes of upper gastrointestinal bleeding in COVID‐19: A systematic review and meta‐analysis
Sawai Singh Rathore, Zario Shai Wint, Aman Goyal, Bijay Mukesh Jeswani, Ameer Mustafa Farrukh, María Alejandra Nieto‐Salazar, Thanmai Reddy Thugu, Snigdha Erva, Raafay Mehmood, Adriana Carolina Toro‐velandia, Hamam Aneis, Sunny Ratnani, Ibrahim Marouf Yas
Reviews in Medical Virology.2024;[Epub] CrossRef
Inpatient outcomes of inflammatory bowel disease in hospitalized patients with COVID-19: analysis of a nationally representative sample
Mohammad Aldiabat, Saqr Alsakarneh, Tyrell Daniel, Muhammad Ali Butt, Balaji Jagdish, James Rock, Aarushi Sudan, Majd Al-Ahmad, Ahmad Jabri, Yassine Kilani, Tarek Odah, Laith Alhuneafat, Mir Zulqarnain, Jana G. Hashash, Hassan Ghoz
Baylor University Medical Center Proceedings.2024; 37(2): 239. CrossRef
Rates, Risk Factors, and Outcomes of Nonvariceal Upper Gastrointestinal Bleeding in Patients Hospitalized for COVID-19 in the United States
Mohammad Aldiabat, Wesam Aleyadeh, Taimur Muzammil, Kemi Adewuyi, Majd Alahmad, Ahmad Jabri, Laith Alhuneafat, Yassine Kilani, Saqr Alsakarneh, Mohammad Bilal
Current Medical Science.2024; 44(6): 1202. CrossRef
Increasing inpatient mortality of nonvariceal upper gastrointestinal bleeding during the COVID-19 pandemic: a nationwide retrospective cohort study
Waqas Rasheed, Gnanashree Dharmarpandi, Ola Al-Jobory, Anass Dweik, Muhammad Anil, Sameer Islam
Baylor University Medical Center Proceedings.2023; 36(3): 286. CrossRef
Outcomes in Patients Admitted for Upper Gastrointestinal Bleeding and COVID-19 Infection: A Study of Two Years of the Pandemic
Sergiu Cazacu, Daniela Burtea, Vlad Iovănescu, Dan Florescu, Sevastița Iordache, Adina Turcu-Stiolica, Victor Sacerdotianu, Bogdan Ungureanu
Life.2023; 13(4): 890. CrossRef
Prevalence, causes, medical interventions, and mortality outcome of acute gastrointestinal bleeding among COVID-19 inpatients
Mai N. Luu, Thinh P. Dang, Minh-Cong H. Vo, Duc T. Quach
Current Medical Research and Opinion.2023; 39(5): 731. CrossRef
Gastrointestinal Bleeding in Patients With New Coronavirus Infection COVID-19
V. D. Anosov, S. A. Domrachev, S. V. Ovchinnikov, N. O. Solovyov
Russian Sklifosovsky Journal "Emergency Medical Care".2023; 12(3): 458. CrossRef
Clinical and Endoscopic Outcomes in COVID-19 Patients With Gastrointestinal Bleeding
Hassan Ashktorab, Tiziano Russo, Gholamreza Oskrochi, Giovanni Latella, Sara Massironi, Martina Luca, Lakshmi G. Chirumamilla, Adeyinka O. Laiyemo, Hassan Brim
Gastro Hep Advances.2022; 1(4): 487. CrossRef
Clinical Characteristics of Hospitalized COVID-19 Patients Who Have Gastrointestinal Bleeds Requiring Intervention: A Case-Control Study
Ahmad Abulawi, Ali Al-Tarbsheh, Annie Leamon, Paul Feustel, Amit Chopra, Asra Batool
Cureus.2022;[Epub] CrossRef
Clinical features of thrombosis and bleeding in COVID-19
Mari R. Thomas, Marie Scully
Blood.2022; 140(3): 184. CrossRef
Mortality Rate in Upper Gastrointestinal Bleeding Associated with Anti-Thrombotic Therapy Before and During Covid-19 Pandemic
Petrica Popa, Sevastita Iordache, Dan Nicolae Florescu, Vlad Florin Iovanescu, Alexandru Vieru, Valentin Barbu, Maria-Cristina Bezna, Dragos Ovidiu Alexandru, Bogdan Silviu Ungureanu, Sergiu Marian Cazacu
Journal of Multidisciplinary Healthcare.2022; Volume 15: 2679. CrossRef
Coronavirus Disease in the Abdomen
Mark A. Anderson, Mark A. Khauli, Reece J. Goiffon, Avinash Kambadakone
Advances in Clinical Radiology.2022; 4(1): 25. CrossRef
Сauses, risk factors, diagnostics and treatment of gastrointestinal bleeding in patients with a novel coronavirus infection (COVID-19)
A. A. Sheptulin, S. S. Kardasheva, A. A. Kurbatova
Clinical Medicine (Russian Journal).2022; 100(7-8): 341. CrossRef
The frequency of ulcerative-erosive defects and ulcerative bleeding of the gastroduodenal zone in patients with coronavirus infection COVID-19
N. N. Butorin, V. V. Tsukanov, R. V. Asyayev, M. N. Butorina, A. V. Vasyutin, J. L. Tonkikh
Experimental and Clinical Gastroenterology.2022; (5): 5. CrossRef

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Seasonal Impacts on the Incidence of Esophageal Variceal Hemorrhage: A Nationwide Analysis across a Decade: Mohamed Tausif Siddiqui, Mohammad Bilal, Khwaja Fahad Haq, Christopher Nabors, Beth Schorr-Lesnick, David C. Wolf; Clin Endosc 2020;53(2):189-195. Published online December 27, 2019; DOI: https://doi.org/10.5946/ce.2019.094

Abstract PDF PubReader ePub

Background
/Aims: Seasonal variation has previously been reported in relation to the incidence of non-variceal upper gastrointestinal bleeding; however, the impact of seasonal variation on variceal bleeding is not known.
Methods
We conducted a cross-sectional study using the Nationwide Inpatient Sample database from 2005 to 2014. International Classification of Diseases, Clinical Modification- 9th Revision codes were used to identify patients hospitalized with a primary or secondary diagnosis of esophageal variceal hemorrhage. The data were analyzed based on the month of hospitalization. Our primary aim was to assess seasonal variations in variceal bleeding-related hospitalizations. The secondary aims were to assess the impact of seasonal variation on outcomes in variceal bleeding including in-hospital mortality and healthcare resource utilization.
Results
A total of 348,958 patients hospitalized with esophageal variceal bleeding were included. The highest number of hospitalizations was reported in December (99.3/day) and the lowest was reported in June (90.8/day). In-hospital mortality was highest in January (11.5%) and lowest in June (9.8%). There was no significant difference in hospital length of stay or total hospitalization costs across all months in all years combined.
Conclusions
There appears to be a seasonal variation in the incidence and mortality of variceal hemorrhage in the United States. December was the month with the highest number of daily hospitalizations while the nadir occurred in June.

Citations

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Seasonal Variation of Esophageal Variceal Bleeding in Brazzaville
Pérès Mardochée Motoula Latou, Rody Stéphane Ngami, Evodie Syntyche Motoula Latou, Ngala Akoa Itoua Ngaporo, Lesty Ibara Kolo, Marlyse Ngalessami Mouakosso, Moria Gilga Ibobi, Bénédicte Ahombo Niotsebe, Bienvenu Hostaud Atipo Ibara, Sandra Céline Adoua, J
Open Journal of Gastroenterology.2025; 15(11): 685. CrossRef
Association between periodic variation of air temperature, humidity, atmospheric pressure and hospital admissions for acute occlusive mesenteric ischaemia
Lin Chen, Jun Wang, Hongqing Zhuo, Zexin Wang, Jizhun Zhang
Scientific Reports.2024;[Epub] CrossRef
Assessing the Predictive Factors for Bleeding in Esophageal Variceal Disease: A Systematic Review
Camila Guinazu, Adolfo Fernández Muñoz, Maria D Maldonado, Jeffry A De La Cruz, Domenica Herrera, Victor S Aruana, Ernesto Calderon Martinez
Cureus.2023;[Epub] CrossRef
α-Adrenergic blockade prevented environmental temperature reduction-induced transient portal pressure surge in cirrhotic and portal hypertensive rats
Hui-Chun Huang, Ching-Chih Chang, Chon Kit Pun, Ming-Hung Tsai, Chiao-Lin Chuang, Shao-Jung Hsu, Yi-Hsiang Huang, Ming-Chih Hou, Fa-Yauh Lee
Clinical Science.2022; 136(20): 1449. CrossRef
Establishment and Evaluation of a Time Series Model for Predicting the Seasonality of Acute Upper Gastrointestinal Bleeding
Zhaoli Fu, Xujie Xi, Beiping Zhang, Yanfeng Lin, Aling Wang, Jianmin Li, Ming Luo, Tianwen Liu
International Journal of General Medicine.2021; Volume 14: 2079. CrossRef
Are there Seasonal Variations in the Incidence and Mortality of Esophageal Variceal Bleeding?
Jeong Ill Suh
Clinical Endoscopy.2020; 53(2): 107. CrossRef

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A Nationwide Assessment of the “July Effect” and Predictors of Post-Endoscopic Retrograde Cholangiopancreatography Sepsis at Urban Teaching Hospitals in the United States: Rupak Desai, Upenkumar Patel, Shreyans Doshi, Dipen Zalavadia, Wardah Siddiq, Hitanshu Dave, Mohammad Bilal, Vikas Khullar, Hemant Goyal, Madhav Desai, Nihar Shah; Clin Endosc 2019;52(5):486-496. Published online May 27, 2019; DOI: https://doi.org/10.5946/ce.2018.190

Abstract PDF PubReader ePub

Background
/Aims: To analyze the incidence of post-endoscopic retrograde cholangiopancreatography (ERCP) sepsis in the early (July to September) and later (October to June) academic months to assess the “July effect”.
Methods
The National Inpatient Sample (2010–2014) was used to identify ERCP-related adult hospitalizations at urban teaching hospitals by applying relevant procedure codes from the International Classification of Diseases, 9th revision, Clinical Modification. Post-ERCP outcomes were compared between the early and later academic months. A multivariate analysis was performed to evaluate the odds of post-ERCP sepsis and its predictors.
Results
Of 481,193 ERCP procedures carried out at urban teaching hospitals, 124,934 were performed during the early academic months. The demographics were comparable for ERCP procedures performed during the early and later academic months. A higher incidence (9.4% vs. 8.8%, p<0.001) and odds (odds ratio [OR], 1.07) of post-ERCP sepsis were observed in ERCP performed during the early academic months. The in-hospital mortality rate (7% vs. 7.5%, p=0.072), length of stay, and total hospital charges in patients with post-ERCP sepsis were also equivalent between the 2 time points. Pre-ERCP cholangitis (OR, 3.20) and post-ERCP complications such as cholangitis (OR, 6.27), perforation (OR, 3.93), and hemorrhage (OR, 1.42) were significant predictors of higher post-ERCP sepsis in procedures performed during the early academic months.
Conclusions
The July effect was present in the incidence of post-ERCP sepsis, and academic programs should take into consideration the predictors of post-ERCP sepsis to lower health-care burden.

Citations

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Frailty as a Predictor of Outcomes in Patients With Post–Endoscopic Retrograde Cholangiopancreatography Pancreatitis
Camilo J. Acosta, Sunil Amin, Jodie A. Barkin
Pancreas.2026; 55(2): e220. CrossRef
The July Effect on Mortality, Hospital Length of Stay, and Time to Colonoscopy Among Patients Presenting to Teaching Hospitals With LGIB in the United States
Eugene Annor, Chima Amadi, Joseph Atarere, Nneoma Ubah, Oluwatayo J. Awolumate, Adedeji Adenusi, Geraldine Nabiryo Nabeta, Darrell Downs, Ayokunle T. Abegunde
Journal of Clinical Gastroenterology.2025;[Epub] CrossRef
A Nationwide Study of the “July Effect” Concerning Postpartum Hemorrhage and Its Risk Factors at Teaching Hospitals across the United States
Zahra Shahin, Gulzar H. Shah, Bettye A. Apenteng, Kristie Waterfield, Hani Samawi
Healthcare.2023; 11(6): 788. CrossRef
July effect in clinical outcomes of esophagogastroduodenoscopy performed at teaching hospitals in the United States
Karthik Gangu, Sanket Basida, Rehmat Ullah Awan, Mohammad Ali Butt, Austin Reed, Rao Afzal, Rahul Shekhar, Harleen Kaur Chela, Ebubekir S. Daglilar, Abu Baker Sheikh
Baylor University Medical Center Proceedings.2023; 36(4): 478. CrossRef
Increased ERCP volume improves cholangiogram interpretation: a new performance measure for ERCP training?
Shyam Vedantam, Sunil Amin, Ben Maher, Saqib Ahmad, Shanil Kadir, Saad Khalid Niaz, Mark Wright, Nadeem Tehami
Clinical Endoscopy.2022; 55(3): 426. CrossRef
Post-ERCP Pancreatitis: Prevention, Diagnosis and Management
Oscar Cahyadi, Nadeem Tehami, Enrique de-Madaria, Keith Siau
Medicina.2022; 58(9): 1261. CrossRef
Risk factors for infections after endoscopic retrograde cholangiopancreatography (ERCP): a retrospective cohort analysis of US Medicare Fee-For-Service claims, 2015–2021
Susan Hutfless, Yasutoshi Shiratori, Daniel Chu, Simon Liu, Anthony Kalloo
BMJ Open.2022; 12(9): e065077. CrossRef
Clinical coaches and patient safety – Just in time: A descriptive exploratory study
Lorraine Thompson, Frances Lin, Annette Faithfull-Byrne, Judith Gonzalez, Amanda Naumann, Kathryn Geisler, Cheryle Moss
Nurse Education in Practice.2021; 54: 103134. CrossRef
Is the July Effect Real in Patients Undergoing Endoscopic Retrograde Cholangiopancreatography?
Tae Yoon Lee, Yousuke Nakai
Clinical Endoscopy.2019; 52(5): 399. CrossRef

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Predictors of Rebleeding in Upper Gastrointestinal Dieulafoy Lesions: Sang-Hun Park, Du-Hyeon Lee, Chang-Hwan Park, Jin Jeon, Ho-Jun Lee, Sung-Uk Lim, Seon-Young Park, Hyun-Soo Kim, Sung-Kyu Choi, Jong-Sun Rew; Clin Endosc 2015;48(5):385-391. Published online September 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.5.385

Abstract PDF PubReader ePub

Background/Aims

Dieulafoy lesions (DLs) are a rare but significant cause of upper gastrointestinal bleeding. We aimed to define the clinical significance of rebleeding and identify the predictors of rebleeding and mortality in upper gastrointestinal Dieulafoy lesions (UGIDLs).

Methods

Patients diagnosed with UGIDLs between January 2004 and June 2013 were retrospectively evaluated. Multivariate logistic regression analyses were performed to define the predictors of rebleeding and mortality in patients with UGIDLs.

Results

The study group consisted of 81 male and 36 female patients. Primary hemostasis was achieved in 115 out of 117 patients (98.3%) with various endoscopic therapies. Rebleeding occurred in 10 patients (8.5%). The mortality rate was significantly higher in patients with rebleeding than in those without rebleeding (30.0% vs. 4.7%, p=0.020). Multivariate logistic regression analysis revealed that kidney disease (p=0.006) and infection (p=0.005) were significant predictors of rebleeding in UGIDLs and that kidney disease (p=0.004) and platelet count (p=0.013) were significant predictors of mortality.

Conclusions

Rebleeding has an important prognostic significance in patients with UGIDLs. Kidney disease and infection are major predictors of rebleeding and mortality in patients with UGIDLs.

Citations

Citations to this article as recorded by

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Clinical Application of AIMS65 Scores to Predict Outcomes in Patients with Upper Gastrointestinal Hemorrhage: Ragesh Babu Thandassery, Manik Sharma, Anil K John, Khalid Mohsin Al-Ejji, Hamidulla Wani, Khaleel Sultan, Muneera Al-Mohannadi, Rafie Yakoob, Moutaz Derbala, Nazeeh Al-Dweik, Muhammed Tariq Butt, Saad Rashid Al-Kaabi; Clin Endosc 2015;48(5):380-384. Published online September 30, 2015; DOI: https://doi.org/10.5946/ce.2015.48.5.380

Abstract PDF PubReader ePub

Background/Aims

To evaluate the ability of the recently proposed albumin, international normalized ratio (INR), mental status, systolic blood pressure, age >65 years (AIMS65) score to predict mortality in patients with acute upper gastrointestinal bleeding (UGIB).

Methods

AIMS65 scores were calculated in 251 consecutive patients presenting with acute UGIB by allotting 1 point each for albumin level <30 g/L, INR >1.5, alteration in mental status, systolic blood pressure ≤90 mm Hg, and age ≥65 years. Risk stratification was done during the initial 12 hours of hospital admission.

Results

Intensive care unit (ICU) admission, endoscopic therapy, or surgery were required in 51 patients (20.3%), 64 (25.5%), and 12 (4.8%), respectively. The predictive accuracy of AIMS65 scores ≥2 was high for blood transfusion (area under the receiver operator characteristic curve [AUROC], 0.59), ICU admission (AUROC, 0.61), and mortality (AUROC, 0.74). The overall mortality was 10.3% (n=26), and was 3%, 7.8%, 20%, 36%, and 40% for AIMS65 scores of 0, 1, 2, 3, and 4, respectively; these values were significantly higher in those with scores ≥2 (30.9%) than in those with scores <2 (4.5%, p<0.001).

Conclusions

AIMS65 is a simple, accurate, non-endoscopic risk score that can be applied early (within 12 hours of hospital admission) in patients with acute UGIB. AIMS65 scores ≥2 predict high in-hospital mortality.

Citations

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Has Any Improvement been Made in the Clinical Outcome of Patients with Bleeding Peptic Ulcer in the Part 10 Years?: Jin Wook Choi, M.D., Hak Yang Kim, M.D., Kyung Ho Kim, M.D., Ja Young Lee, M.D.,Gwang Ho Baek, M.D., Myoung Kuk Jang, M.D., Joon Young Park, M.D.,Jin Heon Lee, M.D. and Jae Young Yoo, M.D.; Korean J Gastrointest Endosc 2005;30(5):235-242. Published online May 30, 2005

Abstract PDF: Background
/Aims: Bleeding still remains as one of the major medical problems in peptic ulcer diseases, despite of the advances in therapeutic options and endoscopic therapy. The aim of this study was to compare the clinical outcomes of bleeding peptic ulcer between two distinct periods in the past ten years. Methods: We divided the among 10 years, we selected the two distinct periods; the first (1993∼1995) and the second (2000∼2002). The clinical and endoscopic characteristics in patients with bleeding peptic ulcer were compared between the two periods. We also analyzed the changes in the clinical outcomes as well. Results: The age of patients during the second period was significantly older compare to the first period. In subgroup analysis, proportions of patients older than 60 years and of female patients were significantly higher in the second period. The percentage of the patients with co-morbid illness, such as diabetes mellitus, cardiovascular diseases, or users of non-steroidal anti- inflammatory drugs, was higher in the second period. Despite the decreasing the frequency of urgent surgery in the second period, there was no significant difference in the rate of re-bleeding and mortality between both periods. Conclusions: Despite the advances in therapeutic options in the second period, no significant difference was found in the prognosis of bleeding ulcer, compared to the first period. Old age, co-morbid illness, and increasing usage of NSAIDs has may contributed to this. Taken together, it might be more important to apply preventive measures to the patients who have risk factors for bleeding peptic ulcer. (Korean J Gastrointest Endosc 2005;30:235⁣242)

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