Abstract | OBJECTIVE: BACKGROUND: METHODS: After spontaneous cessation of bleeding, patients were randomly assigned to conservative treatment (n = 27) or high-dose barium impaction therapy (n = 27). Patients were followed up for 1 year after enrollment of the last patient. The main outcome measure was rebleeding. RESULTS: Median follow-up period was 584.5 days. The probability of rebleeding at 30-day, 180-day, 1-year, and 2-year follow-up in all patients was 3.7%, 14.8%, 28.4%, and 32.7%, respectively. By group, probability at 1 year was 42.5% in the conservative group and 14.8% in the barium group (log-rank test, P = 0.04). After adjustment for a history of hypertension, the hazard ratio of rebleeding in the barium group was 0.34 (95% confidence interval, 0.12-0.98). No complications or laboratory abnormalities due to barium therapy were observed. Compared with the conservative group, the barium group had significantly (P < 0.05) fewer hospitalizations per patient (1.7 vs 1.2), units of blood transfused (1.9 vs 0.7), colonoscopies (1.4 times vs 1.1 times), and hospital stay days (15 days vs 11 days) during the follow-up period. No patients died and none required angiographic or surgical procedures in either group. CONCLUSIONS:
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Authors | Naoyoshi Nagata, Ryota Niikura, Takuro Shimbo, Naoki Ishizuka, Kazuyoshi Yamano, Kyoko Mizuguchi, Junichi Akiyama, Mikio Yanase, Masashi Mizokami, Naomi Uemura |
Journal | Annals of surgery
(Ann Surg)
Vol. 261
Issue 2
Pg. 269-75
(Feb 2015)
ISSN: 1528-1140 [Electronic] United States |
PMID | 25569028
(Publication Type: Comparative Study, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
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Chemical References |
- Hemostatics
- Barium Sulfate
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Topics |
- Adult
- Aged
- Aged, 80 and over
- Barium Sulfate
(therapeutic use)
- Colonic Diseases
(etiology, prevention & control)
- Diverticulum, Colon
(complications)
- Enema
- Female
- Follow-Up Studies
- Gastrointestinal Hemorrhage
(etiology, prevention & control)
- Hemostatics
(therapeutic use)
- Humans
- Kaplan-Meier Estimate
- Male
- Middle Aged
- Proportional Hazards Models
- Recurrence
- Treatment Outcome
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