|
KMID : 0988920180160030458
|
|
Intestinal Research
2018 Volume.16 No. 3 p.458 ~ p.466
|
|
|
Risk factors for severity of colonic diverticular hemorrhage
|
|
Kinjo Ken
Matsui Toshiyuki
Hisabe Takashi
Ishihara Hiroshi
Kojima Toshiki
Chuman Kenta
Yasukawa Shigeyoshi
Beppu Tsuyoshi
Koga Akihiro
Ishikawa Satoshi
Kishi Masahiro
Takatsu Noritaka
Hirai Fumihito
Yao Kenshi
Ueki Toshiharu
Washio Masakazu
|
|
|
Abstract
|
|
|
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. Some cases, however, require surgery or arterial embolization. In this study, using a cohort at Fukuoka University Chikushi Hospital, we investigated factors associated with severe colonic DH.
Methods: Among patients with LGIB who underwent colonoscopy at our hospital between 1995 and 2013, DH was identified in 273 patients. Among them, 62 patients (22.7%) were defined as having severe colonic DH according to recurrence of bleeding in a short period, and/or the necessity of transfusion, arterial embolization, or surgery. We then evaluated risk factors for severe DH among DH patients in this retrospective cohort.
Results: Among the 273 patients with DH, use of non-steroidal anti-inflammatory drugs (NSAIDs) (odds ratio [OR], 2.801; 95% confidence interval [CI], 1.164?6.742), Charlson Risk Index (CRI) ≥2 (OR, 3.336; 95% CI, 1.154?7.353), right-sided colonic DH (OR, 3.873; 95% CI, 1.554?9.653), and symptoms of cerebral hypoperfusion (such as light-headedness, dizziness, or syncope) (OR, 2.926; 95% CI, 1.310?6.535) showed an increased risk of severe DH even after controlling for other factors.
Conclusions: Severe DH occurred in 23% of DH patients, and NSAID use, CRI ≥2, right-sided colonic DH, and symptoms of cerebral hypoperfusion are suggested to be predictors of severe DH.
|
|
|
KEYWORD
|
|
|
Colonic diverticular hemorrhage, Severity risk factors, Anti-inflammatory agents, non-steroidal, Right-sided colonic diverticular hemorrhage
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|
|