title: Analysis of Risk Factors for Colonic Diverticular Bleeding: A Matched Case-Control Study.
abstract: OBJECTIVE
  Diverticular bleeding can occasionally cause massive bleeding that requires urgent colonoscopy (CS) and treatment. The aim of this study was to identify significant risk factors for colonic diverticular hemorrhage.
  
  
  METHODS
  Between January 2009 and December 2012, 26,602 patients underwent CS at our institution. One hundred twenty-three patients underwent an urgent CS due to acute lower gastrointestinal hemorrhage. Seventy-two patients were diagnosed with colonic diverticular hemorrhage. One hundred forty-nine age- and sex-matched controls were selected from the patients with nonbleeding diverticula who underwent CS during the same period. The relationship of risk factors to diverticular bleeding was compared between the cases and controls.
  
  
  RESULTS
  Uni- and multivariate conditional logistic regression analyses demonstrated that the use of nonsteroidal anti-inflammatory drugs (odds ratio [OR], 14.70; 95% confidence interval [CI], 3.89 to 55.80; p<0.0001), as well as the presence of cerebrovascular disease (OR, 8.66; 95% CI, 2.33 to 32.10; p=0.00126), and hyperuricemia (OR, 15.5; 95% CI, 1.74 to 138.00; p=0.014) remained statistically significant predictors of diverticular bleeding.
  
  
  CONCLUSIONS
  Nonsteroidal anti-inflammatory drugs, cerebrovascular disease and hyperuricemia were significant risks for colonic diverticular hemorrhage. The knowledge obtained from this study may provide some insight into the diagnostic process for patients with lower gastrointestinal bleeding.
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.|Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Yuusaku
authors.initials: Y
authors.lastname: Sugihara
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Shin-ei
authors.initials: SE
authors.lastname: Kudo
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Miyachi
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Masashi
authors.initials: M
authors.lastname: Misawa
authors.affiliation: Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan.
authors.forename: Shogo
authors.initials: S
authors.lastname: Okoshi
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.affiliation: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Okayama, Japan.
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D016022:Case-Control Studies; D002561:Cerebrovascular Disorders / Q000150:complications; D003108:Colonic Diseases / Q000209:etiology* / Q000601:surgery; D003113:Colonoscopy; D004241:Diverticulum, Colon / Q000150:complications* / Q000473:pathology / Q000601:surgery; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000601:surgery; D006801:Humans; D033461:Hyperuricemia / Q000150:complications; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal
keywords: Anti-inflammatory agents, non-steroidal; Cerebrovascular disease; Colonoscopy; Diverticular bleeding; Hyperuricemia