Author(s): Watanabe S, Kodera S, Shimura H
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Abstract AIM: Colonic diverticular hemorrhage often recurs. Several studies have identified risk factors for recurrence, but to our knowledge, none have focused on risk factors in the clinical situation. The present study aimed to identify risk factors for the recurrence of hemorrhage and to create a recurrence risk score. METHOD: Hospitalized patients diagnosed with diverticular bleeding from 2008 to 2013 (N = 151) were included in a retrospective cohort study. Risk factors predicting re-bleeding were identified using multivariate analysis, and a risk score was developed using receiver operator characteristic (ROC) analysis. RESULTS: Recurrence was identified in 52 patients (34.4\%) at a median interval of 11.5 months. A history of hypertension and hyperlipidemia, a faster heart rate on admission, and longer hospitalization period were significant risk factors for re-bleeding. We developed a re-bleeding risk score by using these 4 factors; the area under the curve of ROC curve was 0.8. With this risk score, if the cut-off point is 7, then the sensitivity is very high (94\%; specificity: 26\%); if the cutoff point is 14, the specificity is very high (97\%; sensitivity: 40\%). This enables the division of patients into 3 groups: high risk, intermediate risk, and low risk. CONCLUSION: Colonic diverticular hemorrhage often recurs, and patients have high recurrence rates within short periods. Risk factors for re-bleeding include a history of hypertension and hyperlipidemia, faster heart rate, and longer hospitalization period, and the risk score may supply useful information for clinicians to aid management.
This article was published in Acta Gastroenterol Belg
and referenced in Journal of Colitis & Diverticulitis