{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T02:26:27Z","timestamp":1767666387909,"version":"3.40.5"},"reference-count":40,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T00:00:00Z","timestamp":1675641600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J of Gastro and Hepatol"],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background and Aim<\/jats:title><jats:p>The clinical severity and course of acute lower gastrointestinal bleeding (ALGIB) are believed to differ between inpatient\u2010onset and outpatient\u2010onset cases, but no reports have investigated these issues in detail. We aimed to evaluate the clinical differences between inpatient\u2010onset and outpatient\u2010onset ALGIB.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Medical records of patients who had undergone emergency colonoscopy for ALGIB were retrospectively reviewed. The severity was evaluated using the NOBLADS score. Patients with obvious ALGIB relapse and\/or persistent iron\u2010deficiency anemia after emergency colonoscopy were considered to exhibit a poor clinical course.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We reviewed 723 patients with ALGIB and divided them into the inpatient\u2010onset cohort (172 patients) and outpatient\u2010onset cohort (551 patients). Compared with the outpatient\u2010onset cohort, the inpatient\u2010onset cohort had a significantly higher proportion of patients with a poor clinical course (51.2% <jats:italic>vs<\/jats:italic> 21.6%; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001) and a significantly higher mean NOBLADS score (3.6\u00a0\u00b1\u00a01.1 <jats:italic>vs<\/jats:italic> 2.5\u00a0\u00b1\u00a01.0; <jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001). The most common bleeding source was acute hemorrhagic rectal ulcer (52.3%) in the inpatient\u2010onset cohort and colonic diverticular bleeding (29.4%) in the outpatient\u2010onset cohort. Multivariate analysis showed that a platelet count\u00a0&lt;\u00a015\u00a0\u00d7\u00a010<jats:sup>4<\/jats:sup>\/\u03bcL and albumin concentration\u00a0&lt;\u00a03\u00a0g\/dL were significantly associated with a poor clinical course in the inpatient\u2010onset cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The clinical course was significantly worse in the inpatient\u2010onset cohort than in the outpatient\u2010onset cohort. The bleeding source, clinical characteristics, and clinical course differed between the inpatient\u2010onset and outpatient\u2010onset cohorts. The clinical course in the inpatient\u2010onset cohort may depend on the patient's condition at ALGIB onset.<\/jats:p><\/jats:sec>","DOI":"10.1111\/jgh.16134","type":"journal-article","created":{"date-parts":[[2023,1,27]],"date-time":"2023-01-27T18:47:52Z","timestamp":1674845272000},"page":"775-782","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Differences between patients with inpatient\u2010onset and outpatient\u2010onset acute lower gastrointestinal bleeding: An observational study"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3211-995X","authenticated-orcid":false,"given":"Minoru","family":"Fujita","sequence":"first","affiliation":[{"name":"Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine Kawasaki Medical School General Medical Center  Okayama 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