Risk factors for severity of colonic diverticular hemorrhage
| Autor: | Satoshi Ishikawa, Tsuyoshi Beppu, Hiroshi Ishihara, Kenshi Yao, Fumihito Hirai, Noritaka Takatsu, Akihiro Koga, Shigeyoshi Yasukawa, Masakazu Washio, Masahiro Kishi, Toshiki Kojima, Toshiharu Ueki, Takashi Hisabe, Kenta Chuman, Ken Kinjo, Toshiyuki Matsui |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
Lower gastrointestinal bleeding Colonoscopy lcsh:Medicine Colonic diverticular hemorrhage Gastroenterology 03 medical and health sciences 0302 clinical medicine Internal medicine Medicine lcsh:RC799-869 Right-sided colonic diverticular hemorrhage medicine.diagnostic_test business.industry Incidence (epidemiology) lcsh:R Retrospective cohort study Odds ratio medicine.disease Anti-inflammatory agents non-steroidal Confidence interval 030220 oncology & carcinogenesis Cohort Severity risk factors 030211 gastroenterology & hepatology lcsh:Diseases of the digestive system. Gastroenterology Original Article business Rare disease |
| Zdroj: | Intestinal Research Intestinal Research, Vol 16, Iss 3, Pp 458-466 (2018) |
| ISSN: | 2288-1956 1598-9100 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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