Development of risk scores for early and late recurrence of colonic diverticular hemorrhage

Area of Science:

• Gastroenterology
• Clinical Medicine
• Medical Informatics

Background:

• Colonic diverticular hemorrhage (CDH) is a common condition with a significant risk of recurrence.
• Existing research suggests early rebleeding (ER) and late rebleeding (LR) require independent consideration, yet a unified risk assessment system is absent.

Purpose of the Study:

• To develop and validate risk scores for predicting both early and late rebleeding in patients diagnosed with CDH.

Main Methods:

• A retrospective cohort study involving 218 patients across two centers from 2008 to 2021.
• Multivariate analysis was employed to identify independent risk factors for ER and LR.
• Risk scores were constructed based on the odds ratios derived from the identified risk factors.

Main Results:

• The study identified specific risk factors for ER (high heart rate, early endoscopy, no bowel preparation, no endoscopic treatment) and LR (hypertension, diabetes, early endoscopy, endoscopic clips).
• The developed ER risk score demonstrated an AUC of 0.71, with high sensitivity (90.3%) at a cutoff of 6 and high specificity (98.0%) at a cutoff of 15.
• The LR risk score achieved an AUC of 0.70, showing high sensitivity (91.1%) at a cutoff of 2.6 and high specificity (88.3%) at a cutoff of 7.1.

Conclusions:

• Novel risk scoring systems for both early and late rebleeding in CDH have been successfully developed.
• These scores offer a practical tool for clinicians to stratify CDH patients by rebleeding risk, thereby informing management strategies.