Cargando…
Risk factors for severity of colonic diverticular hemorrhage
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 ble...
Autores principales: | , , , , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Korean Association for the Study of Intestinal Diseases
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077309/ https://www.ncbi.nlm.nih.gov/pubmed/30090045 http://dx.doi.org/10.5217/ir.2018.16.3.458 |
_version_ | 1783344884927692800 |
---|---|
author | Kinjo, Ken Matsui, Toshiyuki Hisabe, Takashi Ishihara, Hiroshi Kojima, Toshiki Chuman, Kenta Yasukawa, Shigeyoshi Beppu, Tsuyoshi Koga, Akihiro Ishikawa, Satoshi Kishi, Masahiro Takatsu, Noritaka Hirai, Fumihito Yao, Kenshi Ueki, Toshiharu Washio, Masakazu |
author_facet | Kinjo, Ken Matsui, Toshiyuki Hisabe, Takashi Ishihara, Hiroshi Kojima, Toshiki Chuman, Kenta Yasukawa, Shigeyoshi Beppu, Tsuyoshi Koga, Akihiro Ishikawa, Satoshi Kishi, Masahiro Takatsu, Noritaka Hirai, Fumihito Yao, Kenshi Ueki, Toshiharu Washio, Masakazu |
author_sort | Kinjo, Ken |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-6077309 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Korean Association for the Study of Intestinal Diseases |
record_format | MEDLINE/PubMed |
spelling | pubmed-60773092018-08-08 Risk factors for severity of colonic diverticular hemorrhage Kinjo, Ken Matsui, Toshiyuki Hisabe, Takashi Ishihara, Hiroshi Kojima, Toshiki Chuman, Kenta Yasukawa, Shigeyoshi Beppu, Tsuyoshi Koga, Akihiro Ishikawa, Satoshi Kishi, Masahiro Takatsu, Noritaka Hirai, Fumihito Yao, Kenshi Ueki, Toshiharu Washio, Masakazu Intest Res Original Article 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. Korean Association for the Study of Intestinal Diseases 2018-07 2018-07-27 /pmc/articles/PMC6077309/ /pubmed/30090045 http://dx.doi.org/10.5217/ir.2018.16.3.458 Text en © Copyright 2018. Korean Association for the Study of Intestinal Diseases. http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Kinjo, Ken Matsui, Toshiyuki Hisabe, Takashi Ishihara, Hiroshi Kojima, Toshiki Chuman, Kenta Yasukawa, Shigeyoshi Beppu, Tsuyoshi Koga, Akihiro Ishikawa, Satoshi Kishi, Masahiro Takatsu, Noritaka Hirai, Fumihito Yao, Kenshi Ueki, Toshiharu Washio, Masakazu Risk factors for severity of colonic diverticular hemorrhage |
title | Risk factors for severity of colonic diverticular hemorrhage |
title_full | Risk factors for severity of colonic diverticular hemorrhage |
title_fullStr | Risk factors for severity of colonic diverticular hemorrhage |
title_full_unstemmed | Risk factors for severity of colonic diverticular hemorrhage |
title_short | Risk factors for severity of colonic diverticular hemorrhage |
title_sort | risk factors for severity of colonic diverticular hemorrhage |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6077309/ https://www.ncbi.nlm.nih.gov/pubmed/30090045 http://dx.doi.org/10.5217/ir.2018.16.3.458 |
work_keys_str_mv | AT kinjoken riskfactorsforseverityofcolonicdiverticularhemorrhage AT matsuitoshiyuki riskfactorsforseverityofcolonicdiverticularhemorrhage AT hisabetakashi riskfactorsforseverityofcolonicdiverticularhemorrhage AT ishiharahiroshi riskfactorsforseverityofcolonicdiverticularhemorrhage AT kojimatoshiki riskfactorsforseverityofcolonicdiverticularhemorrhage AT chumankenta riskfactorsforseverityofcolonicdiverticularhemorrhage AT yasukawashigeyoshi riskfactorsforseverityofcolonicdiverticularhemorrhage AT bepputsuyoshi riskfactorsforseverityofcolonicdiverticularhemorrhage AT kogaakihiro riskfactorsforseverityofcolonicdiverticularhemorrhage AT ishikawasatoshi riskfactorsforseverityofcolonicdiverticularhemorrhage AT kishimasahiro riskfactorsforseverityofcolonicdiverticularhemorrhage AT takatsunoritaka riskfactorsforseverityofcolonicdiverticularhemorrhage AT hiraifumihito riskfactorsforseverityofcolonicdiverticularhemorrhage AT yaokenshi riskfactorsforseverityofcolonicdiverticularhemorrhage AT uekitoshiharu riskfactorsforseverityofcolonicdiverticularhemorrhage AT washiomasakazu riskfactorsforseverityofcolonicdiverticularhemorrhage |