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

Takaaki Kishino¹, Tomonori Aoki², Eiji Sadashima³, Katsumasa Kobayashi⁴, Atsushi Yamauchi⁵, Atsuo Yamada², Jun Omori⁶, Takashi Ikeya⁷, Taiki Aoyama⁸, Naoyuki Tominaga⁹, Yoshinori Sato¹⁰, Naoki Ishii¹¹, Tsunaki Sawada¹², Masaki Murata¹³, Akinari Takao¹⁴, Kazuhiro Mizukami¹⁵, Ken Kinjo¹⁶, Shunji Fujimori¹⁷, Takahiro Uotani¹⁸, Minoru Fujita¹⁹, Hiroki Sato²⁰, Sho Suzuki²¹, Toshiaki Narasaka²², Junnosuke Hayasaka²³, Tomohiro Funabiki²⁴, Yuzuru Kinjo²⁵, Akira Mizuki²⁶, Shu Kiyotoki²⁷, Tatsuya Mikami²⁸, Ryosuke Gushima²⁹, Hiroyuki Fujii³⁰, Yuta Fuyuno³¹, Naohiko Gunji³², Yosuke Toya³³, Kazuyuki Narimatsu³⁴, Noriaki Manabe³⁵, Koji Nagaike³⁶, Tetsu Kinjo³⁷, Yorinobu Sumida³⁸, Sadahiro Funakoshi³⁹, Kiyonori Kobayashi⁴⁰, Tamotsu Matsuhashi⁴¹, Yuga Komaki⁴², Mitsuru Kaise⁶, Naoyoshi Nagata^{43

44}

Affiliations

¹ Department of Gastroenterology and Hepatology, Centre for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan.
² Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
³ Department of Medical Research Institute, Saga-Ken Medical Centre Koseikan, Saga, Japan.
⁴ Department of Gastroenterology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
⁵ Department of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
⁶ Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan.
⁷ Department of Gastroenterology, St. Luke's International University, Tokyo, Japan.
⁸ Department of Gastroenterology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
⁹ Department of Gastroenterology, Saga Medical Centre Koseikan, Saga, Japan.
¹⁰ Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
¹¹ Department of Gastroenterology, Tokyo Shinagawa Hospital, Tokyo, Japan.
¹² Department of Endoscopy, Nagoya University Hospital, Aichi, Japan.
¹³ Department of Gastroenterology, National Hospital Organization Kyoto Medical Centre, Kyoto, Japan.
¹⁴ Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Centre Komagome Hospital, Tokyo, Japan.
¹⁵ Department of Gastroenterology, Oita University, Oita, Japan.
¹⁶ Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
¹⁷ Department of Gastroenterology, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
¹⁸ Department of Gastroenterology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
¹⁹ Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Centre, Okayama, Japan.
²⁰ Division of Gastroenterology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
²¹ Department of Gastroenterology and Hepatology, Centre for Digestive Disease and Division of Endoscopy, University of Miyazaki Hospital, Miyazaki, Japan.
²² Department of Gastroenterology, University of Tsukuba, Ibaraki, Japan.
²³ Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
²⁴ Emergency and Critical Care Centre, Saiseikai Yokohama Tobu Hospital, Kanagawa, Japan.
²⁵ Department of Gastroenterology, Naha City Hospital, Okinawa, Japan.
²⁶ Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan.
²⁷ Department of Gastroenterology, Shuto General Hospital, Yamaguchi, Japan.
²⁸ Division of Endoscopy, Hirosaki University Hospital, Aomori, Japan.
²⁹ Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
³⁰ Department of Gastroenterology and Hepatology, National Hospital Organization Fukuokahigashi Medical Centre, Fukuoka, Japan.
³¹ Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
³² Department of Gastroenterology, Fukushima Medical University, Fukushima, Japan.
³³ Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan.
³⁴ Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
³⁵ Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Okayama, Japan.
³⁶ Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Osaka, Japan.
³⁷ Department of Endoscopy, University of the Ryukyus Hospital, Okinawa, Japan.
³⁸ Department of Gastroenterology, National Hospital Organization Kyushu Medical Centre, Fukuoka, Japan.
³⁹ Department of Gastroenterological Endoscopy, Fukuoka University Hospital, Fukuoka, Japan.
⁴⁰ Department of Gastroenterology, Kitasato University, School of Medicine, Kanagawa, Japan.
⁴¹ Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan.
⁴² Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
⁴³ Department of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan.
⁴⁴ Department of Gastroenterology and Hepatology, National Centre for Global Health and Medicine, Tokyo, Japan.

PMID: 37787161
DOI: 10.1111/codi.16751

Review

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

Takaaki Kishino et al. Colorectal Dis. 2023 Nov.

. 2023 Nov;25(11):2206-2216.

doi: 10.1111/codi.16751. Epub 2023 Oct 3.

Authors

Affiliations

¹ Department of Gastroenterology and Hepatology, Centre for Digestive and Liver Diseases, Nara City Hospital, Nara, Japan.
² Department of Gastroenterology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
³ Department of Medical Research Institute, Saga-Ken Medical Centre Koseikan, Saga, Japan.
⁴ Department of Gastroenterology, Tokyo Metropolitan Bokutoh Hospital, Tokyo, Japan.
⁵ Department of Gastroenterology and Hepatology, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan.
⁶ Department of Gastroenterology, Nippon Medical School, Graduate School of Medicine, Tokyo, Japan.
⁷ Department of Gastroenterology, St. Luke's International University, Tokyo, Japan.
⁸ Department of Gastroenterology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan.
⁹ Department of Gastroenterology, Saga Medical Centre Koseikan, Saga, Japan.
¹⁰ Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine, Kanagawa, Japan.
¹¹ Department of Gastroenterology, Tokyo Shinagawa Hospital, Tokyo, Japan.
¹² Department of Endoscopy, Nagoya University Hospital, Aichi, Japan.
¹³ Department of Gastroenterology, National Hospital Organization Kyoto Medical Centre, Kyoto, Japan.
¹⁴ Department of Gastroenterology, Tokyo Metropolitan Cancer and Infectious Diseases Centre Komagome Hospital, Tokyo, Japan.
¹⁵ Department of Gastroenterology, Oita University, Oita, Japan.
¹⁶ Department of Gastroenterology, Fukuoka University Chikushi Hospital, Fukuoka, Japan.
¹⁷ Department of Gastroenterology, Chiba Hokusoh Hospital, Nippon Medical School, Chiba, Japan.
¹⁸ Department of Gastroenterology, Japanese Red Cross Shizuoka Hospital, Shizuoka, Japan.
¹⁹ Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School General Medical Centre, Okayama, Japan.
²⁰ Division of Gastroenterology, Graduate School of Medical and Dental Sciences, Niigata University, Niigata, Japan.
²¹ Department of Gastroenterology and Hepatology, Centre for Digestive Disease and Division of Endoscopy, University of Miyazaki Hospital, Miyazaki, Japan.
²² Department of Gastroenterology, University of Tsukuba, Ibaraki, Japan.
²³ Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan.
²⁴ Emergency and Critical Care Centre, Saiseikai Yokohama Tobu Hospital, Kanagawa, Japan.
²⁵ Department of Gastroenterology, Naha City Hospital, Okinawa, Japan.
²⁶ Department of Internal Medicine, Tokyo Saiseikai Central Hospital, Tokyo, Japan.
²⁷ Department of Gastroenterology, Shuto General Hospital, Yamaguchi, Japan.
²⁸ Division of Endoscopy, Hirosaki University Hospital, Aomori, Japan.
²⁹ Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.
³⁰ Department of Gastroenterology and Hepatology, National Hospital Organization Fukuokahigashi Medical Centre, Fukuoka, Japan.
³¹ Department of Medicine and Clinical Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
³² Department of Gastroenterology, Fukushima Medical University, Fukushima, Japan.
³³ Division of Gastroenterology, Department of Internal Medicine, Iwate Medical University, Iwate, Japan.
³⁴ Department of Internal Medicine, National Defense Medical College, Saitama, Japan.
³⁵ Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Okayama, Japan.
³⁶ Department of Gastroenterology and Hepatology, Suita Municipal Hospital, Osaka, Japan.
³⁷ Department of Endoscopy, University of the Ryukyus Hospital, Okinawa, Japan.
³⁸ Department of Gastroenterology, National Hospital Organization Kyushu Medical Centre, Fukuoka, Japan.
³⁹ Department of Gastroenterological Endoscopy, Fukuoka University Hospital, Fukuoka, Japan.
⁴⁰ Department of Gastroenterology, Kitasato University, School of Medicine, Kanagawa, Japan.
⁴¹ Department of Gastroenterology and Neurology, Akita University Graduate School of Medicine, Akita, Japan.
⁴² Digestive and Lifestyle Diseases, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan.
⁴³ Department of Gastroenterological Endoscopy, Tokyo Medical University, Tokyo, Japan.
⁴⁴ Department of Gastroenterology and Hepatology, National Centre for Global Health and Medicine, Tokyo, Japan.

PMID: 37787161
DOI: 10.1111/codi.16751

Abstract

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.

Keywords: acute lower gastrointestinal bleeding; colonic diverticular haemorrhage; delayed feeding; early feeding; fasting; length of hospital stay.

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References

REFERENCES

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

Affiliations

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

Authors

Affiliations

Abstract

References

REFERENCES

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical