Minhem MA, Nakshabandi A, Mirza R, Alsamman MA, Mattar MC. Gastrointestinal hemorrhage in the setting of gastrointestinal cancer: Anatomical prevalence, predictors, and interventions. World J Gastrointest Endosc 2021; 13(9): 391-406 [PMID: 34630889 DOI: 10.4253/wjge.v13.i9.391]
Corresponding Author of This Article
Mark C Mattar, AGAF, FACG, Associate Professor, Department of Gastroenterology, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007, United States. mark.c.mattar@medstar.net
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Endosc. Sep 16, 2021; 13(9): 391-406 Published online Sep 16, 2021. doi: 10.4253/wjge.v13.i9.391
Gastrointestinal hemorrhage in the setting of gastrointestinal cancer: Anatomical prevalence, predictors, and interventions
Mohamad A Minhem, Ahmad Nakshabandi, Rabia Mirza, Mohd Amer Alsamman, Mark C Mattar
Mohamad A Minhem, Internal Medicine, Loyola University Medical Center, Maywood, IL 60153, United States
Ahmad Nakshabandi, Mohd Amer Alsamman, Mark C Mattar, Department of Gastroenterology, Medstar Georgetown University Hospital, Washington, DC 20007, United States
Rabia Mirza, Mark C Mattar, School of Medicine, Georgetown University, Washington, DC 20007, United States
Author contributions: Minhem MA contributed to study concept and design, statistical analysis of data, and drafting of manuscript; Nakshabandi A supervised the report and contributed to interpretation of data and editing of manuscript; Mirza R contributed to interpretation of data and drafting of manuscript; Alsamman MA contributed to interpretation of data and editing of manuscript; Mattar MC supervised the report and provided critical revision of important intellectual concepts.
Institutional review board statement: Not required because study involves only de-identified data.
Informed consent statement: Not required because study involves only de-identified data.
Conflict-of-interest statement: All authors have no relevant disclosures.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Mark C Mattar, AGAF, FACG, Associate Professor, Department of Gastroenterology, Medstar Georgetown University Hospital, 3800 Reservoir Rd NW, Washington, DC 20007, United States. mark.c.mattar@medstar.net
Received: April 21, 2021 Peer-review started: April 21, 2021 First decision: June 23, 2021 Revised: June 27, 2021 Accepted: August 6, 2021 Article in press: August 6, 2021 Published online: September 16, 2021
ARTICLE HIGHLIGHTS
Research background
Gastrointestinal hemorrhage (GIH) is a common complication with gastrointestinal cancers (GIC).
Research motivation
There is no comprehensive research that examines GIH in different types of GIC. Furthermore, endoscopic therapy is insufficiently studied in this setting.
Research objectives
We aim to study the prevalence, predictors, and interventions of GIH based on the anatomical location of GIC.
Research methods
This is a retrospective analysis of the 2016-2018 National Inpatient Sample database, the largest inpatient care database in the United States. Adult inpatients were evaluated for the prevalence and predictors of GIH in the setting of GIC. In addition, inpatient mortality was compared between patients who underwent or did not undergo endoscopy.
Research results
The highest to lowest GIH rates are listed in the following order: stomach cancer (15.7%), liver cancer (13.0%), small bowel cancer (12.7%), esophageal cancer (9.1%), colorectal cancer (9.1%), pancreatic cancer (7.2%), bile duct cancer (6.0%), and gallbladder cancer (5.1%). Inpatient mortality was significantly lower in patients who underwent endoscopy compared to no endoscopy [5.5% vs 14.9%, OR = 0.42 (0.38-0.46)], P < 0.001).
Research conclusions
The prevalence of GIH in patients with GIC varies significantly based on the tumor’s anatomical location. Endoscopy appears to be associated with a substantial reduction in inpatient mortality and should be offered to GIC patients with GIH.
Research perspectives
Future studies, prospective and randomized trials, would help confirm the effectiveness of endoscopic therapy for GIH in patients with GIC.
