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International Journal of Colorectal Disease
Published in: International Journal of Colorectal Disease 1/2023

01-12-2023 | Gastrointestinal Bleeding | RESEARCH

Anatomical location, risk factors, and outcomes of lower gastrointestinal bleeding in colorectal cancer patients: a national inpatient sample analysis (2009–2019)

Authors: Chengu Niu, Jing Zhang, Jie Lian, Joshi Utsav, Charoo Iyer, SoonKhai Low, Hassan Saeed, Salman Zahid, Patrick I. Okolo 3rd

Published in: International Journal of Colorectal Disease | Issue 1/2023

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Abstract

Purpose

This study aimed to investigate the incidence, predictors, and impact of lower gastrointestinal bleeding (LGIB) on inpatient mortality among colorectal cancer patients, due to its clinical significance and potential influence on patient outcomes.

Methods

We conducted a retrospective analysis of data from the National Inpatient Sample database between 2009 and 2019, including 2,598,326 colorectal cancer patients with and without LGIB. Univariate and multivariate logistic regression analyses were performed to determine predictors of LGIB and its association with inpatient outcomes.

Results

The highest incidence of LGIB was observed in rectal cancer patients (3.8%), followed by distal colon cancer patients (1.4%) and proximal colon cancer patients (1.2%). Several factors were significantly associated with LGIB, including older age; male sex; certain racial such as Black, Hispanic, and Asia/Pacific Islander patients; or lower socioeconomic status. Multivariate analysis identified independent predictors of LGIB, such as severe sepsis, use of anticoagulants, long-term use of aspirin or antiplatelet drugs, palliative care, malnutrition, cachexia, chemotherapy or immunotherapy, metastasis, alcohol abuse, hypertension, obesity, and family history of digestive cancer. No significant difference in inpatient mortality was observed between patients with and without LGIB.

Conclusion

Our study underscores the importance of considering colorectal cancer location and identified risk factors for LGIB assessment. Clinicians should address modifiable risk factors and healthcare disparities. Future research should explore underlying mechanisms, targeted interventions, and long-term outcomes beyond inpatient mortality.
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Metadata
Title
Anatomical location, risk factors, and outcomes of lower gastrointestinal bleeding in colorectal cancer patients: a national inpatient sample analysis (2009–2019)
Authors
Chengu Niu
Jing Zhang
Jie Lian
Joshi Utsav
Charoo Iyer
SoonKhai Low
Hassan Saeed
Salman Zahid
Patrick I. Okolo 3rd
Publication date
01-12-2023
Publisher
Springer Berlin Heidelberg
Published in
International Journal of Colorectal Disease / Issue 1/2023
Print ISSN: 0179-1958
Electronic ISSN: 1432-1262
DOI
https://doi.org/10.1007/s00384-023-04503-9

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