Risk factors and outcomes of acute lower gastrointestinal bleeding in intestinal Behçet’s disease
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Intestinal Behçet’s disease (BD) can cause acute lower gastrointestinal bleeding, which is sometimes fatal.
We aimed to identify the risk factors and outcomes of acute lower gastrointestinal bleeding and factors associated with rebleeding in intestinal BD patients.
Of the total of 588 intestinal BD patients, we retrospectively reviewed the medical records of 66 (11.2%) patients with acute lower gastrointestinal bleeding and compared them with those of 132 matched patients without bleeding.
The baseline characteristics were comparable between the bleeding group (n = 66) and the non-bleeding group (n = 132). On multivariate analysis, the independent factors significantly associated with lower gastrointestinal bleeding were older age (>52 years) (hazard ratio [HR] 2.2, 95% confidence interval [CI] 1.058–4.684, p = 0.035) and a nodular ulcer margin (HR 7.1, 95% CI 2.084–24.189, p = 0.002). Rebleeding occurred in 23 patients (34.8%). Female patients (p = 0.044) and those with previous use of corticosteroids or azathioprine (p = 0.034) were more likely to develop rebleeding. On multivariate analysis, only use of steroids or azathioprine was significantly associated with rebleeding (HR 3.2, 95% CI 1.070–9.462, p = 0.037).
Age >52 years and the presence of a nodular margin of the ulcer were found to be related to increased risk of bleeding in patients with intestinal BD. Rebleeding is not uncommon and not effectively prevented with currently available medications. Further studies are warranted to identify effective measures to decrease rebleeding in intestinal BD.
KeywordsBehçet’s disease Gastrointestinal hemorrhage Risk factor Outcome Rebleeding
Jihye Park: acquisition of data; analysis and interpretation of data; drafting of the manuscript. Yong Eun Park: acquisition of data. Yoon Jee Lee: acquisition of data. Hyun Jung Lee: study concept and design; critical revision of the manuscript for important intellectual content. Soo Jung Park: study concept and design; critical revision of the manuscript for important intellectual content. Sung Pil Hong: study concept and design; critical revision of the manuscript for important intellectual content. Tae Il Kim: study concept and design; critical revision of the manuscript for important intellectual content. Won Ho Kim: study concept and design; critical revision of the manuscript for important intellectual content. Jae Hee Cheon: acquisition of data; study concept and design; critical revision of the manuscript for important intellectual content.
Compliance with ethical standards
This study was conducted in accordance with the ethical guidelines of the Declaration of Helsinki and approved by the ethics committee of Severance Hospital.
Conflict of interest
The authors declare that they have no conflict of interest.
Guarantor of the article
Jae Hee Cheon.
This research was supported by two grants (A120176, HI13C1345) from the Korean Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), which is funded by the Ministry of Health and Welfare, Republic of Korea. This work was also supported by two grants (NRF-2013R1A2A2A01067123, NRF-2014R1A1A1008096) from the Basic Science Research Program through the National Research Foundation of Korea, which is funded by the Ministry of Science, ICT and Future Planning. In addition, this work was supported by a faculty research grant (2012-31-0477) from the Department of Internal Medicine, Yonsei University, College of Medicine.
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