Multivariate predictors of severe LGIB (NOBLADS factors) as defined in the previous study (n = 439).

<p>[<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0196514#pone.0196514.ref014" target="_blank">14</a>].</p

Prediction of severe bleeding using the NOBLADS score in the external validation cohort.

<p>Error bars show the standard errors.</p

Receiver operator characteristic curves of NOBLADS scores for severe LGIB in the derivation (n = 439)[14], internal validation (n = 161)[14], and external validation cohorts (n = 511).

<p>AUC, area under receiver operating characteristic curve.</p

Prediction of adverse clinical outcomes using the NOBLADS score in the external validation cohorts.

<p>A, proportion of patients who required blood transfusions; B, mean length of stay in hospital; C, proportion of patients who required intervention; and D, proportion of death during hospitalization. Error bars show the standard errors.</p

Flow chart of patient selection.

<p>LGIB, lower gastrointestinal bleeding; UGIB, upper gastrointestinal bleeding.</p

Patient characteristics.

<p>Patient characteristics.</p

Prevalence of diverticulosis (A) and anatomic distribution (B) by age category (n = 2,164).

<p>Colonic diverticulosis increased with age (A). The prevalence of right-sided diverticula was high at for younger age, while left-sided and bilateral types increased with age (B).</p

Prevalence of diverticulosis and anatomic distribution by alcohol consumption (A) and smoking index (B) (n = 2,164).

<p>Right-sided and bilateral diverticula increased significantly in line with amount of alcohol consumption (A). All distribution types of colonic diverticula increased significantly in line with smoking index (SI) (B).</p

Adverse Events during Bowel Preparation and Colonoscopy in Patients with Acute Lower Gastrointestinal Bleeding Compared with Elective Non-Gastrointestinal Bleeding

<div><p>Background</p><p>There are limited data on the safety of colonoscopy in patients with lower gastrointestinal bleeding (LGIB). We examined the various adverse events associated with colonoscopy in acute LGIB compared with non-GIB patients.</p><p>Methods</p><p>Emergency hospitalized LGIB patients (n = 161) and age- and gender-matched non-GIB controls (n = 161) were selected. Primary outcomes were any adverse events during preparation and colonoscopy procedure. Secondary outcomes were five bowel preparation-related adverse events–hypotension, systolic blood pressure <100 mmHg, volume overload, vomiting, aspiration pneumonia and loss of consciousness–and four colonoscopy-related adverse events–including hypotension, perforation, cerebrocardiovascular events and sepsis.</p><p>Results</p><p>During bowel preparation, 16 (9%) LGIB patients experienced an adverse event. None of the LGIB patients experienced volume overload, aspiration pneumonia or loss of consciousness; however, 12 (7%) had hypotension and 4 (2%) vomited. There were no significant differences in the five bowel preparation-related adverse events between LGIB and non-GIB patients. During colonoscopy, 25 (15%) LGIB patients experienced an adverse event. None LGIB patient had perforation or sepsis; however, 23 (14%) had hypotension and 2 (1%) experienced a cerebrocardiovascular event. There was no significant difference in the four colonoscopy-related adverse events between LGIB and non-GIB patients. In addition, no significant difference in any of the nine adverse events was found among subgroups: patients aged ≥65 years, those with comorbidities, and those with antithrombotic drug use.</p><p>Conclusions</p><p>Adverse events in bowel preparation and colonoscopy among acute LGIB patients were low. No significant difference was found in adverse events between LGIB and non-GIB patients. These adverse events were also low in elderly LGIB patients, as well as in those with co-morbidities and antithrombotic drug use, suggesting that colonoscopy performed during acute LGIB did not increase adverse events.</p></div

Factors associated with colonic diverticulosis on multivariate analysis.

<p>^* The smoking index was evaluated among ever and daily smokers and was defined as the number of cigarettes per day multiplied by the number of smoking years.</p