title: Recurrence of colonic diverticular bleeding and associated risk factors.
abstract: OBJECTIVE
  Colonic diverticular bleeding often recurs, but the risk factors remain unclear. Our aim was to identify risk factors for recurrence in patients with diverticular bleeding.
  
  
  METHODS
  Seventy-two hospitalized patients who were diagnosed with diverticular bleeding between 2004 and 2008 were analyzed. Rebleeding was considered as the main outcome measure, with the duration until recurrence identified from medical records. Potential risk factors for rebleeding, such as underlying pathologies, medication and smoking and drinking habits, were investigated from the medical records on initial admission.
  
  
  RESULTS
  Of the 72 patients, 19 had a diverticular disease on the right, 16 on the left side and 37 on both sides of the colon. Recurrence was identified in 27 (38%) patients at a median interval of 1535 days. The cumulative incidence of rebleeding at 6, 12 and 24 months was 15%, 20% and 33%. Multivariate analysis revealed nonsteroid anti-inflammatory drugs (NSAIDs) (hazard ratio (HR), 2.57; 95% confidence interval (CI), 0.89-7.46; P=0.08), antiplatelet drugs (HR, 2.39; 95% CI, 1.01-5.67; P=0.05) and hypertension (HR, 4.16; 95% CI, 1.22-14.2; P=0.02) to be risk factors for rebleeding.
  
  
  CONCLUSIONS
  Patients with colonic diverticular bleeding show high recurrence rates within a short period. Risk factors for recurrence have been identified as the use of NSAIDs or antiplatelet drugs and hypertension.
authors.affiliation: Department of Gastroenterology, National Center for Global Health and Medicine, Tokyo, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Niikura
authors.forename: N
authors.initials: N
authors.lastname: Nagata
authors.forename: A
authors.initials: A
authors.lastname: Yamada
authors.forename: J
authors.initials: J
authors.lastname: Akiyama
authors.forename: T
authors.initials: T
authors.lastname: Shimbo
authors.forename: N
authors.initials: N
authors.lastname: Uemura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D015331:Cohort Studies; D003108:Colonic Diseases / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D004241:Diverticulum, Colon / Q000473:pathology*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D006973:Hypertension / Q000150:complications; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects; D016016:Proportional Hazards Models; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D010975:Platelet Aggregation Inhibitors