Recurrence of colonic diverticular bleeding and associated risk factors. Niikura, R., Nagata, N., Yamada, A., Akiyama, J., Shimbo, T. and Uemura, N. Colorectal Disease 2012; 14: 302–305.
Aim Colonic diverticular bleeding often recurs, but the risk factors remain unclear. Our aim was to identify risk factors for recurrence in patients with diverticular bleeding.
Method Seventy-two hospitalized patients who were diagnosed with diverticular bleeding between 2004 and 2008 were analyzed. Rebleeding was considered as the main outcome measure, with the duration until recurrence identified from medical records. Potential risk factors for rebleeding, such as underlying pathologies, medication and smoking and drinking habits, were investigated from the medical records on initial admission. Results Of the 72 patients, 19 had a diverticular disease on the right, 16 on the left side and 37 on both sides of the colon. Recurrence was identified in 27 (38%) patients at a median interval of 1535 days. The cumulative incidence of rebleeding at 6, 12 and 24 months was 15%, 20% and 33%. Multivariate analysis revealed nonsteroid anti-inflammatory drugs (NSAIDs) (hazard ratio (HR), 2.57; 95% confidence interval (CI), 0.89–7.46; P = 0.08), antiplatelet drugs (HR, 2.39; 95% CI, 1.01–5.67; P = 0.05) and hypertension (HR, 4.16; 95% CI, 1.22–14.2; P = 0.02) to be risk factors for rebleeding. Conclusion Patients with colonic diverticular bleeding show high recurrence rates within a short period. Risk factors for recurrence have been identified as the use of NSAIDs or antiplatelet drugs and hypertension. leggi l’articolo