SHM Converge Scientific Abstract ePoster Gallery-Admission Predictors and Acute Care Outcomes in Young Adults Presenting to the Ed With First-Time Hematochezia

Admission Predictors and Acute Care Outcomes in Young Adults Presenting to the Ed With First-Time Hematochezia

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This retrospective cohort study used the TriNetX Research Network to examine adults aged 18–44 with a first emergency department diagnosis of hematochezia over 20 years, excluding those with prior colorectal cancer or colorectal surgery. The cohort included 81,943 patients, with outcomes tracked for 365 days.<br /><br />The study found that most young adults with hematochezia were ultimately diagnosed with benign anorectal conditions. At 1 year, the most common diagnoses were hemorrhoids (25.3%) and anal fissures (4.7%). More serious conditions were less common, including diverticular disease (3.2%), inflammatory bowel disease (1.6%), and malignancy (0.03%). All-cause mortality was low at 0.53%.<br /><br />Despite the low rate of serious disease, healthcare utilization remained substantial, and repeat visits were common. Colonoscopy was performed in only 10.6% of patients within one year, suggesting uncertainty in selecting patients for endoscopic evaluation and limited follow-up after the initial ED visit.<br /><br />Admission decisions were better predicted by systemic or concerning features such as nausea/vomiting, hypotension, anemia, and acute kidney injury, rather than abdominal pain alone.<br /><br />Overall, the study concludes that hematochezia in young adults is usually due to benign causes, but clinically significant disease is still possible. The authors suggest that clearer ED triage criteria and structured outpatient follow-up could help reduce repeat visits while avoiding missed diagnoses.

Asset Subtitle

Mustafa Naveed

Meta Tag

Author List Kishu Chaudry, Mustafa Naveed, Zarak Khan

Category Research

Concept Hematochezia

Concept Diagnosis

Concept Cause

Concept Inflammatory Bowel Disease

Concept Emergency Department

Distinguished Non-Finalist

Presenter Organization Virginia Tech Carilion Department of Internal Medicine

Presenting Author Mustafa Naveed

Track Outcomes Research

Keywords

hematochezia

young adults

retrospective cohort

TriNetX Research Network

emergency department

hemorrhoids

anal fissure

colonoscopy

gastrointestinal bleeding

colorectal disease

Hematochezia

Diagnosis

Cause

Inflammatory Bowel Disease

Emergency Department