Repeat colonoscopy’s value in gastrointestinal bleeding

Table 1 Demographic characteristics of study population (n = 139) (%)

Characteristics	Value
Age (yr), mean ± SD (range)	68.2 ± 15.2 (20-92)
Sex
Male	55
Female	45
Race
African-American	76
Caucasian	14
Hispanic	7
Asian	3
Indication of the procedures
Lower gastrointestinal bleeding	88.4
Changes in bowel habit	6.4
Abdominal pain	5
Abnormal imaging studies	0.2
Endoscopist performing the procedures
Same endoscopist	37
Different endoscopist	63
Fellow involvement
No fellow involvement	48.8
Same fellow involvement	7.9
Different fellow involvement	43.3
Duration between procedures in days, mean ± SD (range)	171 ± 31 ( 3-1085)
Within the first year after the index procedure	45.3
Between 1-2 yr after the index procedure	17.3
Between 2-3 yr after the index procedure	37.4
Setting of the procedures
Inpatient procedures	50.4
Outpatient procedures	28.4
Outpatient then inpatient setting	9.1
Inpatient then outpatient setting	12.1

Table 2 New endoscopic findings on the repeat colonoscopy that led to a clinically significant change (n = 25)

Findings	Description	Location
8 previously undetected hemorrhoid lesions (6.5%)	2 small hemorrhoid lesions	Rectum
	2 large hemorrhoid lesions	Rectum
	4 hemorrhoid lesions with no comment on size	Rectum
7 actively bleeding lesions requiring endoscopic interventions (5.7%)	3 arterio-venous malformations	2 in ascending colon
		1 in descending colon
	2 bleeding radiation colitis	Descending colon
	2 bleeding internal hemorrhoids	Rectum
5 previously undetected tubular adenomas (4.1%)	4 smaller-than-1-cm tubular adenomas	1 in sigmoid colon,
		1 in descending colon
		2 in ascending colon
	1 larger-than-1-cm tubular adenoma	Ascending colon
3 radiation colitis (2.43%)		2 in descending colon
		1 in rectum
1 rectal ulcer (0.8%)		Rectum
1 previously undetected cancer (0.8%)	1 large ulcerated mass	Ascending colon

Table 3 Logistic regression analysis of correlation between clinical parameters and clinical significant change

Clinical parameters	Odds ratio	95%CI	P value
Gender (male as reference)	1.83	0.72-4.65	0.205
Age > 60 yr	0.47	0.17-1.28	0.138
Race
Caucasian (reference)	1.00
African-American	3.48	0.43-28.4	0.245
Asian	3.48	0.43-28.4	0.245
Hispanic	9.60	0.85-108.7	0.068
Interval between procedure
< 365 d (reference)	1.00
365–630 d	0.09	0.01-0.74	0.025
630–1095 d	0.26	0.09-0.72	0.010
Hospital setting
Inpatient procedures (reference)	1.00
Outpatient procedures	1.08	0.36-3.23	0.887
Outpatient then inpatient setting	1.26	0.36-4.34	0.718
Inpatient then outpatient setting	1.25	0.34-4.53	0.738
Presenting signs/symptom
Hematochezia	4.31	0.94-19.7	0.059
Occult heme positive stool	0.64	0.13-3.13	0.583
Anemic symptoms	0.86	0.32-2.30	0.771
Hemodynamic instability	1.40	0.4-4.89	0.599
Location of diverticulosis
Right-sided (reference)	1.00
Left-sided	1.78	0.29-11.13	0.535
Pandiverticulosis	0.29	0.36-2.29	0.238
Improved quality of bowel preparation	0.84	0.33-2.17	0.725
Change in endoscopist	0.98	0.39-2.4	0.961
Fellow involvement	2.19	0.87-5.59	0.098
Duration between onset of symptoms and procedure more than 2 d	0.91	0.25-3.25	0.882
Withdrawal time more than 7 min	0.59	0.31-1.14	0.578