title: Investigation of risk factors predicting recurrence of colonic diverticular hemorrhage and development of a recurrence risk score.
abstract: OBJECTIVE
  Colonic diverticular hemorrhage often recurs. Several studies have identified risk factors for recurrence, but to our knowledge, none have focused on risk factors in the clinical situation. The present study aimed to identify risk factors for the recurrence of hemorrhage and to create a recurrence risk score.
  
  
  METHODS
  Hospitalized patients diagnosed with diverticular bleeding from 2008 to 2013 (N = 151) were included in a retrospective cohort study. Risk factors predicting re-bleeding were identified using multivariate analysis, and a risk score was developed using receiver operator characteristic (ROC) analysis.
  
  
  RESULTS
  Recurrence was identified in 52 patients (34.4%) at a median interval of 11.5 months. A history of hypertension and hyperlipidemia, a faster heart rate on admission, and longer hospitalization period were significant risk factors for re-bleeding. We developed a re-bleeding risk score by using these 4 factors; the area under the curve of ROC curve was 0.8. With this risk score, if the cut-off point is 7, then the sensitivity is very high (94%; specificity: 26%); if the cutoff point is 14, the specificity is very high (97%; sensitivity: 40%). This enables the division of patients into 3 groups: high risk, intermediate risk, and low risk.
  
  
  CONCLUSIONS
  Colonic diverticular hemorrhage often recurs, and patients have high recurrence rates within short periods. Risk factors for re-bleeding include a history of hypertension and hyperlipidemia, faster heart rate, and longer hospitalization period, and the risk score may supply useful information for clinicians to aid management.
authors: S
authors: S
authors: Watanabe
authors: S
authors: S
authors: Kodera
authors: H
authors: H
authors: Shimura
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004241:Diverticulum, Colon / Q000175:diagnosis* / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors