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. 2017 Sep;96(38):e8090.
doi: 10.1097/MD.0000000000008090.

Analysis of risk factors for colonic diverticular bleeding and recurrence

Masato Taki  1 , Tadayuki Oshima, Katsuyuki Tozawa, Yukako Taniguchi, Toshihiko Tomita, Yoshio Ohda, Hirokazu Fukui, Jiro Watari, Hiroto Miwa
Affiliations

Analysis of risk factors for colonic diverticular bleeding and recurrence

Masato Taki et al. Medicine (Baltimore). 2017 Sep.

Abstract

The increase in incidence of colonic diverticular bleeding is relative to an age-related rise in the incidence of colonic diverticulosis and use of antithrombotic medication. However, risk factors related to the onset, recurrence, and prophylaxis have not been established. Therefore, we aimed to determine risk factors for the onset and recurrence of colonic diverticular bleeding.An age- and sex-matched case-control study was performed to assess the risk factors for the onset of colonic diverticular bleeding. The distribution of diverticulosis, comorbidity, and medication were evaluated from medical records. We also assigned patients with a first-time bleeding into groups with and without rebleeding during follow-up to determine risk factors for recurrence.Bilateral colonic diverticulosis, nonselective nonsteroidal anti-inflammatory drugs (NSAIDs), low-dose aspirin (LDA), and anticoagulants were significant risk factors for the onset of colonic diverticular bleeding on multivariate analysis. In contrast, the use of selective cyclooxygenase-2 (COX-2) inhibitor was not a risk factor for the onset. The incidence of bleeding in direct oral anticoagulant and warfarin users was not different between the 2 groups. The cumulative recurrence rate at 1 year was 15%. Recurrence rate was significantly higher in patients with a prior history of colonic diverticular bleeding than those without. Steroid use was associated with recurrence.Extensive distribution of diverticulosis and use of nonselective NSAIDs, LDA, and anticoagulants are regarded as risk factors for the onset of colonic diverticular bleeding. In addition, a prior history of colonic diverticular bleeding is related to the recurrence.

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Conflict of interest statement

The authors have no funding and conflicts of interest to disclose.

Figures

Figure 1
Figure 1
Kaplan-Meier estimates of cumulative recurrence rate at the initial admission (A) and for patients who had PH and those that did not (B). PH = prior history.
Figure 2
Figure 2
Kaplan-Meier estimates of cumulative recurrence rate for steroid user and nonuser.
See this image and copyright information in PMC

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