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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...

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Autores principales: 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
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
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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.
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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
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