Risk factors for early re-bleeding and associated hospitalization in patients with colonic diverticular bleeding

Colorectal Dis. 2013 Aug;15(8):982-6. doi: 10.1111/codi.12232.

Abstract

Aim: The annual incidence of colonic diverticular bleeding is increasing, but treatments are not yet well established. Here we aimed to identify the risk factors for early re-bleeding and to determine the associated duration of hospitalization.

Method: Records of 90 emergent patients with colonic diverticular bleeding between 1999 and May 2012 were retrospectively reviewed. They were divided into an early re-bleeding within 1 month group (n = 24) and a no re-bleeding group (n = 66) and we investigated the risk factors for early re-bleeding. In the former group, we calculated the time from the first haemostasis to early re-bleeding and the associated duration of hospitalization.

Results: Univariate analysis showed that there were significantly more patients with signs of shock (P = 0.00055) and active bleeding on the first colonoscopy after admission (P = 0.020) in the early re-bleeding group. Multivariate conditional logistic regression analysis using stepwise variable selection showed that signs of shock on admission (odds ratio, 5.23; 95% confidence interval, 1.84-14.90; P = 0.0019) remained statistically significant. All patients who re-bled without signs of shock (n = 7) and 16 of 17 with signs of shock re-bled within 126 h (5.25 days) of initial hospitalization.

Conclusion: Shock was an independent risk factor for early re-bleeding. The associated duration of hospitalization was 6 days.

Keywords: Colon; diverticulum; gastrointestinal haemorrhage; haemostasis; shock.

MeSH terms

  • Aged
  • Diverticulum, Colon / blood
  • Diverticulum, Colon / complications*
  • Diverticulum, Colon / therapy
  • Female
  • Gastrointestinal Hemorrhage / epidemiology
  • Gastrointestinal Hemorrhage / etiology*
  • Hemostasis / physiology*
  • Humans
  • Incidence
  • Length of Stay / statistics & numerical data
  • Logistic Models
  • Male
  • Middle Aged
  • Odds Ratio
  • Recurrence
  • Retrospective Studies
  • Risk Factors
  • Shock / diagnosis*