Predictors of 90-day Colonic Diverticular Recurrent Bleeding and Readmission

Intern Med. 2019 Aug 15;58(16):2277-2282. doi: 10.2169/internalmedicine.2276-18. Epub 2019 May 22.

Abstract

Objective Colonic diverticular bleeding often recurs, and readmissions are common. The aim of this study was to identify predictors of colonic diverticular recurrent bleeding and readmission within 90 days. Methods Subjects comprised 144 patients diagnosed with colonic diverticular bleeding who received inpatient hospital care between January 2012 and June 2017. A retrospective comparative study was carried out regarding the clinical characteristics during the hospital stay by dividing the cases into 2 groups: patients with recurrent bleeding requiring readmission within 90 days (n=17) and patients without recurrent bleeding (n=127). Results A univariate analysis showed that recurrent bleeding and readmission were significantly more frequent among cases with hypovolemic shock on admission (p=0.009), blood transfusion during hospitalization (p=0.029), and hyperlipidemia (p=0.020) than among others. Shock on admission (odds ratio, 5.118; 95% confidence interval, 1.168-22.426, p=0.030) remained a significant predictor on a multivariate analysis. Conclusion Shock may predict recurrent colonic diverticular bleeding and readmission within 90 days. Careful and adequate endoscopic hemostasis is recommended for patients showing shock on admission.

Keywords: colon; diverticulum; gastrointestinal hemorrhage; patient readmission; shock.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Blood Transfusion / methods
  • Chronic Disease / therapy*
  • Diverticulosis, Colonic / complications*
  • Diverticulosis, Colonic / diagnosis
  • Diverticulosis, Colonic / therapy*
  • Diverticulum, Colon / complications*
  • Female
  • Gastrointestinal Hemorrhage / diagnosis
  • Gastrointestinal Hemorrhage / etiology*
  • Gastrointestinal Hemorrhage / therapy*
  • Hemostasis, Endoscopic / methods
  • Hospitalization / statistics & numerical data
  • Humans
  • Japan
  • Length of Stay / statistics & numerical data
  • Male
  • Middle Aged
  • Odds Ratio
  • Patient Readmission / statistics & numerical data*
  • Recurrence
  • Retrospective Studies
  • Risk Factors