Clinical Characteristics, Interventions and Adverse Outcomes of Acute Lower Gastrointestinal Bleeding: A Cohort Study Conducted in Vietnam

Abstract

Background and Aim: Despite medical advances, the incidence of acute lower gastrointestinal bleeding (ALGIB) is gradually increasing in Asia and Vietnam, with many cases being severe. However, recent data on clinical features, interventions, and outcomes in Vietnam remain limited. This study aims to characterize the presentation, treatment, and outcomes of ALGIB in Vietnamese patients. Method: A retrospective and prospective cohort study was conducted on 222 patients aged 18 years and older with ALGIB at the Department of Gastroenterology, University Medical Center Ho Chi Minh City. Clinical characteristics, interventions, and adverse outcomes were recorded. Results: A total of 222 patients were included in the study, with a female-to-male ratio of 1.02 and a mean age of 63.7 years. Among them, 85.6% were admitted with symptoms of bright red blood per rectum, maroon-colored stool, or stool with clots. The most common causes of acute lower gastrointestinal bleeding were hemorrhoids (20.7%) and colonic diverticulosis (20.3%). The rates of blood transfusion, endoscopic intervention, radiologic intervention, and surgery were 38.7%, 19.4%, 2.7%, and 2.7%, respectively. Severe lower gastrointestinal bleeding was observed in 59 patients (26.6%). There were two in-hospital deaths (0.9%), one related to underlying comorbidities and one due to persistent, uncontrollable bleeding. Conclusion: Hemorrhoids were the most common cause of acute lower gastrointestinal bleeding. The rates of blood transfusion, endoscopic intervention, radiologic intervention, and surgery were 38.7%, 19.4%, 2.7%, and 2.7%, respectively. Overall, 26.6% of cases progressed to severe lower gastrointestinal bleeding.