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

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

Author information

1
Department of Critical Care Medicine, Iwate Medical University, Morioka, Iwate, Japan. yfujino-gi@umin.ac.jp

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

PMID:
23560619
DOI:
10.1111/codi.12232
[Indexed for MEDLINE]
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