Year 2017 / Volume 109 / Number 1
Original
Risk factors for severity and recurrence of colonic diverticular bleeding

3-9

DOI: 10.17235/reed.2016.4190/2015

Natércia Joaquim, Paulo Caldeira, Artur G. Antunes, Marta Eusébio, Horácio Guerreiro,

Abstract
Background: Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding. Risk factors related to severity and repeated bleeding episodes are not completely clearly defined. Objective: To characterize a Portuguese population hospitalized due to colonic diverticular bleeding and to identify the clinical predictors related to bleeding severity and rebleeding. Methods: Retrospective analysis of all hospitalized patients diagnosed with colonic diverticular bleeding from January 2008 to December 2013 at our institution. The main outcomes evaluated were bleeding severity, defined as any transfusion support requirements and/or signs of hemodynamic shock, and 1-year recurrence rate. Results: Seventy-four patients were included, with a mean age of 75.7 ± 9.5 years; the majority were male (62.2%). Thirty-six patients (48.6%) met the criteria for severe bleeding; four independent risk factors for severe diverticular bleeding were identified: low hemoglobin level at admission (≤ 11 g/dL; OR 18.8), older age (≥ 75 years; OR 4.7), bilateral diverticular location (OR 14.2) and chronic kidney disease (OR 5.6). The 1-year recurrence rate was 12.9%. We did not identify any independent risk factor for bleeding recurrence in this population. Conclusion: In this series, nearly half of the patients hospitalized with diverticular bleeding presented with severe bleeding. Patients with low hemoglobin levels, older age, bilateral diverticular location and chronic kidney disease had a significantly increased risk for severe diverticular bleeding. In addition, a small number of patients rebled within the first year after the index episode, although we could not identify independent risk factors associated with the recurrence of diverticular bleeding.
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Joaquim N, Caldeira P, Antunes A, Eusébio M, Guerreiro H. Risk factors for severity and recurrence of colonic diverticular bleeding . 4190/2015


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Publication history

Received: 04/01/2016

Accepted: 13/10/2016

Online First: 07/12/2016

Published: 03/01/2017

Article revision time: 269 days

Article Online First time: 338 days

Article editing time: 365 days


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