Clin Gastroenterology H: Early colonoscopy does not improve prognosis in patients with lower digestive tract bleeding

Background and ObjectivesCurrent guidelines recommend a colonoscopy assessment in patients with high risk or severe acute under-
gastrointestinal(LGIB) within 24 hours of admission or hospitalizationThe meta-analysis of colonoscopy time is mainly dependent on observational research, which has great potential for biasThis study systematically evaluated randomized trials to determine the best time for colonoscopy in acute LGIB inpatientsmethodsresearchers searched a database of papers as of July 2019 to study randomized trials in patients with acute LGIB or hematopoietic diseaseThe researchers compared early colonoscopy (within 24 hours) with selective colonoscopy (24 hours) and/or otherdiagnostictestsThe main observational outcome is further bleeding, defined as persistent or recurrent bleeding after the indicator examinationSecondary results include mortality, endoscopy intervention and any major hemostatic intervention (endoscopy, surgery or radiointervention therapy)results
study included data from four randomized trials In patients receiving selective colonoscopy early and later, there was no reduction in further bleeding (the relative risk of further bleeding in the early colonoscopy was 1.57; 95% CI 0.74-3.31) Secondary mortality (RR, 0.93; 95% CI, 0.05-17.21), diagnostic rate (RR, 1.09; 95% CI, 0.99-1.21), endoscopy intervention (RR, 1.53; 95% CI, 0.67-3.48) no significant differences were found Conclusion
This study found that a colonoscopy within 24 hours did not reduce further bleeding or mortality in acute LGIB inpatients Based on these findings, patients hospitalized with acute LGIB often do not need an early colonoscopy