Abdul M. Kouanda, MD, Ma Somsouk, MD, Justin L

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Presentation transcript:

Urgent colonoscopy in patients with lower GI bleeding: a systematic review and meta- analysis Abdul M. Kouanda, MD, Ma Somsouk, MD, Justin L. Sewell, MD, MPH, Lukejohn W. Day, MD Gastrointestinal Endoscopy Volume 86, Issue 1, Pages 107-117.e1 (July 2017) DOI: 10.1016/j.gie.2017.01.035 Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 1 Results of literature search. Gastrointestinal Endoscopy 2017 86, 107-117.e1DOI: (10.1016/j.gie.2017.01.035) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 2 Forest plot comparing bleeding source localization between urgent and elective colonoscopy performed in patients with lower GI bleeding. A, Time frame of 24 hours for performing an urgent colonoscopy. Heterogeneity: τ2 = .02; I2 = 80.5%; χ2 = 25.63, df = 5 (P ≤ .001). B, Time frame of 12 hours for performing an urgent colonoscopy. Heterogeneity: τ2 = .02; I2 = 60.4%; χ2 = 5.05, df = 2 (P = .08). The left-hand side of the graph favors elective colonoscopy, whereas the right-hand side favors urgent colonoscopy. CI, Confidence interval. Gastrointestinal Endoscopy 2017 86, 107-117.e1DOI: (10.1016/j.gie.2017.01.035) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Figure 3 Forest plot comparing the use of endoscopic therapy between urgent and elective colonoscopy performed in patients with lower GI bleeding. A, Time frame of 24 hours for performing an urgent colonoscopy. Heterogeneity: τ2 = .21; I2 = 73.2%; χ2 = 26.13, df = 7 (P ≤ .001). B, Time frame of 12 hours for performing an urgent colonoscopy. Heterogeneity: τ2 = 1.51; I2 = 76.6%; χ2 = 8.55, df = 2 (P = .01). The left-hand side of the graph favors elective colonoscopy, whereas the right-hand side favors urgent colonoscopy. CI, Confidence interval. Gastrointestinal Endoscopy 2017 86, 107-117.e1DOI: (10.1016/j.gie.2017.01.035) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions

Supplementary Figure 1 Forest plots comparing (A) patients receiving a blood transfusion, (B) rebleeding rate, (C) adverse event rate, and (D) mortality rate between urgent and elective colonoscopy performed in patients with lower GI bleeding. Heterogeneity: A, τ2 = .07; I2 = 85.6%; χ2 = 13.91, df = 2 (P = .001); B, τ2 =.07; I2 = 32.8%; χ2 = 4.46, df = 3 (P = .22); C, τ2 = .17; I2 = 86.6%; χ2 = 29.92, df = 4 (P ≤ .001); D, τ2 = .26; I2 = 17.0%; χ2 = 3.62, df = 3 (P = .31). CI, Confidence interval. Gastrointestinal Endoscopy 2017 86, 107-117.e1DOI: (10.1016/j.gie.2017.01.035) Copyright © 2017 American Society for Gastrointestinal Endoscopy Terms and Conditions