Publications by authors named "Ken Kinjo"
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.
Article Synopsis
- - The study analyzed data from 2699 patients with acute lower gastrointestinal bleeding (ALGIB) to assess the effectiveness of endoscopic treatments based on bleeding location, type, and cause of recent hemorrhage stigmata. - Results showed that rebleeding rates varied significantly by location (15.5% in the left colon vs. 28.6% in the right) and bleeding cause (27.5% for diverticular bleeding vs. 8.9% for other causes), with endoscopic treatment generally reducing overall rebleeding rates. - The findings suggest a tailored endoscopic treatment strategy depending on bleeding location and type, indicating ligation is more effective than clipping for right-colon diverticular bleeding, highlighting the complexity of risks associated
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.
Article Synopsis
- 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: While angioectasia is an important cause of acute hematochezia, relevant clinical features remain unclear. This study aims to reveal risk factors, clinical outcomes, and the effectiveness of therapeutic endoscopy for patients with acute hematochezia due to angioectasia.
Methods: This retrospective cohort study was conducted at 49 Japanese hospitals between January 2010 and December 2019, enrolling patients hospitalized for acute hematochezia (CODE BLUE-J study).
Background: The short-term efficacy of tacrolimus (Tac) for steroid-dependent and steroid-resistant refractory ulcerative colitis (UC) has been demonstrated; however, its long-term outcomes have not been well documented. Thus, this study aimed to clarify the long-term outcomes of patients who achieved Tac-induced remission and identify its predictors.
Methods: This study included patients with moderate-to-severe active UC who started receiving Tac at our hospital between July 2004 and December 2016.
Article Synopsis
- 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.
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).
Treatment strategies for reducing early and late recurrence of colonic diverticular bleeding based on stigmata of recent hemorrhage: a large multicenter study.
Gastrointest Endosc
June 2022
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).
BACKGROUND : Prior studies have shown the effectiveness of both endoscopic band ligation (EBL) and clipping for colonic diverticular hemorrhage (CDH) but have been small and conducted at single centers. Therefore, we investigated which was the more effective and safe treatment in a multicenter long-term cohort study. METHODS : We reviewed data for 1679 patients with CDH who were treated with EBL (n = 638) or clipping (n = 1041) between January 2010 and December 2019 at 49 hospitals across Japan (CODE BLUE-J study).
View Article and Find Full Text PDFIntroduction: The bleeding source of hematochezia is unknown without performing colonoscopy. We sought to identify whether colonoscopy is a risk-stratifying tool to identify etiology and predict outcomes and whether presenting symptoms can differentiate the etiologies in patients with hematochezia.
Methods: This multicenter retrospective cohort study conducted at 49 hospitals across Japan analyzed 10,342 patients admitted for outpatient-onset acute hematochezia.
Article Synopsis
- * A subsequent biopsy revealed that the lesion was signet-ring cell carcinoma, prompting its removal via endoscopic submucosal dissection.
- * Interestingly, the patient had no signs of Helicobacter pylori infection throughout the monitoring period, and this case represents the longest follow-up of gastric signet-ring cell carcinoma in the absence of this infection, spanning 17 years.
Background/aims: Colonic diverticular hemorrhage (DH) was a rare disease until the 1990s, and its incidence has increased rapidly since 2000 in Japan. In recent years, colonic DH has been the most frequent cause of lower gastrointestinal bleeding (LGIB). Nearly all cases of DH are mild, with the bleeding often stopping spontaneously.
View Article and Find Full Text PDFIncrease in colonic diverticular hemorrhage and confounding factors.
World J Gastrointest Pharmacol Ther
August 2016
Article Synopsis
- The study aimed to track changes over time in the causes of lower gastrointestinal bleeding (LGIB) and investigate factors linked to changes in diverticular hemorrhage (DH) from 1995 to 2013.
- A total of 1,803 patients were analyzed, split into early (1995-2006) and late (2007-2013) groups, with findings showing an increase in older patients and DH cases in the later group.
- Factors such as the use of antithrombotic and nonsteroidal anti-inflammatory drugs, male gender, obesity, smoking, alcohol use, and arteriosclerotic diseases were more common in patients with DH, indicating these could help manage such cases.
Background And Aim: The aim of the present study was to endoscopically evaluate ileal mucosal healing during maintenance therapy with infliximab in order to investigate the clinical significance of endoscopic examination of ileal lesions in Crohn's disease patients.
Methods: This study retrospectively analyzed 54 patients who mainly had active ulcers of the ileum on endoscopy at baseline who were responsive to infliximab induction and who received infliximab maintenance therapy. Mucosal healing was defined as no ulcer or only ulcer scar.