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Risk factors for severity of colonic diverticular hemorrhage

Ken Kinjo1, Toshiyuki Matsui1, Takashi Hisabe1

  • 1Department of Gastroenterology, Fukuoka University Chikushi Hospital, Chikushino, Japan.

Intestinal Research
|August 10, 2018
PubMed

Insights

Non-steroidal anti-inflammatory drug use, higher comorbidity scores, right-sided colonic diverticular hemorrhage (DH), and cerebral hypoperfusion symptoms predict severe DH. These findings aid in identifying high-risk patients for this increasingly common cause of lower gastrointestinal bleeding.

Area of Science:

  • Gastroenterology
  • Clinical Medicine
  • Epidemiology

Background:

  • Colonic diverticular hemorrhage (DH) incidence has risen significantly in Japan since 2000, becoming a leading cause of lower gastrointestinal bleeding (LGIB).
  • While most DH cases are mild and self-limiting, a subset requires interventions like surgery or arterial embolization.
  • This study investigates predictors of severe DH in a Japanese cohort.

Purpose of the Study:

  • To identify risk factors associated with severe colonic diverticular hemorrhage (DH).
  • To improve the clinical management of patients experiencing lower gastrointestinal bleeding due to DH.

Main Methods:

  • Retrospective cohort study of 273 patients with DH undergoing colonoscopy from 1995-2013.
  • Severe DH defined by bleeding recurrence, need for transfusion, embolization, or surgery (62 patients, 22.7%).
  • Logistic regression analysis to evaluate risk factors for severe DH.

Main Results:

  • NSAID use (OR 2.801), Charlson Risk Index (CRI) ≥2 (OR 3.336), right-sided colonic DH (OR 3.873), and cerebral hypoperfusion symptoms (OR 2.926) were significant predictors of severe DH.
  • These associations remained significant after adjusting for other factors.
  • 22.7% of DH patients experienced severe bleeding.

Conclusions:

  • NSAID use, CRI ≥2, right-sided colonic DH, and symptoms of cerebral hypoperfusion are key predictors of severe DH.
  • These factors can help clinicians identify patients at higher risk for severe bleeding.
  • Understanding these predictors is crucial for managing the increasing incidence of DH.
Abstract

Keywords:
Anti-inflammatory agents, non-steroidalColonic diverticular hemorrhageRight-sided colonic diverticular hemorrhageSeverity risk factors

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