Publications by authors named "Funabiki T"
Background: Despite accumulating evidence and recommendations for management of colonic diverticular bleeding (CDB), the changes in its clinical management and outcomes remain unknown.
Methods: We performed a retrospective tendency analysis on a biennial basis, a propensity score-matched cohort study between the first and latter half groups, and mediation analyses to compare the diagnostic and treatment methods between January 2010 and December 2019 (CODE BLUE-J Study).
Results: A total of 6575 patients with CDB were included.
Background And Aims: We sought to validate the British Society of Gastroenterology (BSG) guidelines for acute lower gastrointestinal bleeding (ALGIB).
Methods: We analyzed 8,956 patients with ALGIB in CODE BLUE-J study and categorized them into four groups based on BSG guidelines. Outcomes included 30-day rebleeding, 30-day mortality, blood transfusion, therapeutic intervention, and severe bleeding.
Article Synopsis
- The study examined the link between blood group O and the likelihood of rebleeding in patients with acute lower gastrointestinal bleeding (ALGIB).
- Out of 2336 patients analyzed, those with blood group O had higher rebleeding rates within 30 days (17.9%) and 1 year (21.9%) compared to non-O patients.
- Blood group O was found to be an independent risk factor for rebleeding, while rates of thrombosis and mortality were similar between groups.
Article Synopsis
- The study analyzed 8,254 cases of patients with acute lower gastrointestinal bleeding to find key factors that predict mortality and create a reliable prediction tool.
- Researchers established the CACHEXIA score, which uses factors present at admission and management during hospitalization to assess the risk of death within 30 days and 1 year.
- The CACHEXIA score demonstrated high accuracy (ROC-AUC 0.93 for 30 days; C-index 0.88 for 1 year) with significant differentiation of mortality risk, indicating that patients with high scores need continuous monitoring after discharge.
Purpose: This study aimed to elucidate whether immediate angiography within 30 min is associated with lower in-hospital mortality compared with non-immediate angiography.
Materials And Methods: We conducted a retrospective cohort study using a nationwide trauma databank (2019-2020). Adult trauma patients who underwent emergency angiography within 12 h after hospital arrival were included.
Background: Resuscitative endovascular balloon occlusion of the aorta (REBOA) can temporarily control arterial hemorrhage in torso trauma; however, the abdominal visceral blood flow is also blocked by REBOA. The aim of this study was to evaluate the influence of REBOA on gastrointestinal function.
Methods: A retrospective review identified all trauma patients admitted to our trauma center between 2008 and 2019.
Article Synopsis
- A study analyzed data from 10,342 patients with acute lower gastrointestinal bleeding (ALGIB) to better understand surgical rates, procedures, and outcomes.
- Surgery was performed in only 1.3% of patients, with common indications being diverticular bleeding, colorectal cancer, and small bowel bleeding, and the overall mortality rate was 1.5% for those who underwent surgery.
- The findings suggest that identifying the source of bleeding and using endoscopic techniques may lower the need for surgery and enhance treatment for ALGIB.
The Japanese Urological Association's guidelines for the treatment of renal trauma were published in 2016. In conjunction with its revision, herein, we present the new guidelines for overall urotrauma. Its purpose is to provide standard diagnostic and treatment recommendations for urotrauma, including iatrogenic trauma, to preserve organ function and minimize complications and fatality.
View Article and Find Full Text PDFBackground: Nonoperative management (NOM) is the standard treatment for hemodynamically stable blunt splenic injury (BSI). However, NOM failure is a significant source of morbidity and mortality. We developed a clinical risk scoring system for NOM failure in BSI.
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- This study compared the effects of early versus delayed feeding in patients with acute lower gastrointestinal bleeding (ALGIB) after their bleeding was controlled.
- Researchers analyzed data from 5,910 patients across Japan, dividing them into early (feeding within 1 day) and delayed (feeding after 2-3 days) groups.
- Results showed no significant differences in rebleeding rates or need for further treatments between the groups, but the early feeding group had a shorter hospital stay, suggesting it is a safe and beneficial practice.
Article Synopsis
- A study analyzed the impact of weekend admissions on outcomes for patients with acute lower gastrointestinal bleeding in 49 Japanese hospitals from 2010 to 2019.
- The findings showed no significant difference in mortality rates between weekend and weekday admissions, although weekend admissions resulted in a higher need for blood transfusions.
- Additionally, weekend admissions led to delays in early colonoscopy and an increase in urgent CT scans, but overall mortality and other outcomes remained unaffected.
Article Synopsis
- A predictive model called the LONG-HOSP score was developed to assess the risk of prolonged hospital stays for patients admitted with acute lower gastrointestinal bleeding (ALGIB), based on their baseline characteristics.
- The study analyzed data from over 8,500 patients across 49 hospitals to create and validate this model, which includes factors such as age, body mass index, and various lab results.
- Findings revealed that certain conditions and treatments during hospitalization, like colitis diagnosis and early colonoscopy, significantly impacted the length of stay, with early interventions helping to reduce it.
Article Synopsis
- This study compares the effectiveness of short vs. long attachment caps in colonoscopy for identifying causes of acute hematochezia, specifically looking at recent hemorrhage.
- Using data from over 6,400 patients, researchers found that long cap users had significantly higher rates of diagnosing colonic diverticular bleeding and identifying active bleeding, compared to short cap users.
- The conclusion suggests that long cap-assisted colonoscopy is more effective for diagnosing acute hematochezia and recognizing bleeding compared to short caps.
Article Synopsis
- A study analyzed long-term outcomes of 5048 patients hospitalized for acute lower gastrointestinal bleeding (ALGIB) in Japan to understand risks of recurrence after discharge.
- Findings revealed that 25.8% of patients experienced rebleeding within an average follow-up of 31 months, with significant mortality risks increasing for those with out-of-hospital rebleeding episodes.
- Key risk factors for rebleeding included shock index, blood transfusion, in-hospital rebleeding, colonic diverticular bleeding, and thienopyridine use, while endoscopic hemostasis was found to reduce rebleeding risk.
Article Synopsis
- - The study compared the effectiveness of two ligation therapies, endoscopic detachable snare ligation (EDSL) and endoscopic band ligation (EBL), in treating colonic diverticular bleeding (CDB) using data from 518 patients within a multicenter study.
- - Findings revealed no significant differences in outcomes like initial hemostasis, recurrent bleeding within 30 days, mortality, or need for additional interventions between the two treatment groups.
- - Sigmoid colon involvement and a history of acute lower gastrointestinal bleeding (ALGIB) were identified as significant risk factors for long-term recurrent bleeding, emphasizing the need for careful follow-up after ligation therapy.
Article Synopsis
- - The study aimed to create a predictive model for detecting stigmata of recent hemorrhage (SRH) in patients with acute lower gastrointestinal bleeding (LGIB) to prioritize colonoscopy treatment.
- - Researchers analyzed data from 8,360 patients treated in Japan, focusing on various characteristics and factors to develop and validate the CS-NEED score for predicting SRH presence.
- - The CS-NEED score demonstrated strong predictive accuracy, helping to identify which patients were likely to benefit from endoscopic therapy, with higher scores correlating with increased SRH detection rates.
Background: Immediate whole-body CT (about 10 min after arrival) in an all-in-one resuscitation room equipped with CT has been found to be associated with shorter time to haemostasis and lower in-hospital mortality. The aim of this study was to elucidate the benefits of immediate whole-body CT after hospital arrival in patients with severe trauma with the hypothesis that immediate CT within 10 min is associated with lower in-hospital mortality.
Method: This retrospective cohort study of patients with an injury severity score of more than 15 who underwent whole-body CT was conducted using the Japanese Trauma Databank (2019-2020).
Article Synopsis
- The study investigates angioectasia as a cause of acute hematochezia and identifies significant risk factors such as chronic kidney disease, liver disease, female gender, lower body mass index, and anticoagulant use.
- Among the 10,342 patients analyzed, only 1.2% were diagnosed with angioectasia, with this group experiencing a higher need for blood transfusions and a notable incidence of rebleeding.
- Coagulation therapy was found to significantly reduce rebleeding risk compared to conservative management, indicating its effectiveness in treating patients with angioectasia-related hematochezia.
Objective: The objective of this study was to determine the association between arterial embolisation (AE) for pelvic fractures and death.
Methods: The study had a retrospective design, using data from a nationwide population based prospective registry of trauma patients in Japan. This propensity score matched study included all adult patients from the registry with pelvic fractures between January 2004 and December 2018.
Introduction: Post-contrast acute kidney injury (PC-AKI) is a major complication of contrast media usage; risks for PC-AKI are generally evaluated before computed tomography (CT) with contrast at the emergency department (ED). Although persistent hypotension (systolic blood pressure [sBP] <80 mm Hg for 1 h) is associated with increased PC-AKI incidence, it remains unclear whether transient hypotension that is haemodynamically stabilized before CT is a risk of PC-AKI. We hypothesized that hypotension on ED arrival would be associated with higher PC-AKI incidence even if CT with contrast was performed after patients are appropriately resuscitated.
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- The study aimed to find the best timing for colonoscopy in patients with acute lower GI bleeding and to identify factors that could help them.
- Researchers analyzed data from over 6,200 patients who had colonoscopy within 120 hours of bleeding, comparing outcomes based on early (≤24 hours), elective (24-48 hours), and late (48-120 hours) procedures.
- Early colonoscopy led to better identification of recent bleeding and shorter hospital stays but also had a higher rebleeding rate, without affecting mortality or the need for additional interventions; it was especially beneficial for patients with a higher shock index or poor performance status.
Aim: Limited information exists on the factors associated with prolonged procedural time in embolization for trauma patients. We clarified the clinical application of embolization in trauma patients and factors associated with a prolonged procedure time.
Methods: Medical records of 162 trauma patients who underwent embolization between January 2007 and December 2020 at a regional trauma care center were reviewed retrospectively.
Endoscopic direct clipping versus indirect clipping for colonic diverticular bleeding: A large multicenter cohort study.
United European Gastroenterol J
February 2022
Background: Direct and indirect clipping treatments are used worldwide to treat colonic diverticular bleeding (CDB), but their effectiveness has not been examined in multicenter studies with more than 100 cases.
Objective: We sought to determine the short- and long-term effectiveness of direct versus indirect clipping for CDB in a nationwide cohort.
Methods: We studied 1041 patients with CDB who underwent direct clipping (n = 360) or indirect clipping (n = 681) at 49 hospitals across Japan (CODE BLUE-J Study).
Background And Aims: Treatment strategies for colonic diverticular bleeding (CDB) based on stigmata of recent hemorrhage (SRH) remain unstandardized, and no large studies have evaluated their effectiveness. We sought to identify the best strategy among combinations of SRH identification and endoscopic treatment strategies.
Methods: We retrospectively analyzed 5823 CDB patients who underwent colonoscopy at 49 hospitals throughout Japan (CODE-BLUE J-Study).
Aim: Effective courses are essential for highly invasive procedures such as resuscitative endovascular balloon occlusion of the aorta. However, the coronavirus disease pandemic has forced the postponement of on-site educational courses due to transmission concerns. Few studies have examined the effectiveness of Web-based education in highly invasive procedures.
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