title: Risk factors for severity and recurrence of colonic diverticular bleeding.
abstract: BACKGROUND
  Colonic diverticular bleeding is the most common cause of lower gastrointestinal bleeding. Risk factors related to severity and repeated bleeding episodes are not completely clearly defined.
  
  
  OBJECTIVE
  To characterize a Portuguese population hospitalized due to colonic diverticular bleeding and to identify the clinical predictors related to bleeding severity and rebleeding.
  
  
  METHODS
  Retrospective analysis of all hospitalized patients diagnosed with colonic diverticular bleeding from January 2008 to December 2013 at our institution. The main outcomes evaluated were bleeding severity, defined as any transfusion support requirements and/or signs of hemodynamic shock, and 1-year recurrence rate.
  
  
  RESULTS
  Seventy-four patients were included, with a mean age of 75.7 ± 9.5 years; the majority were male (62.2%). Thirty-six patients (48.6%) met the criteria for severe bleeding; four independent risk factors for severe diverticular bleeding were identified: low hemoglobin level at admission (≤ 11 g/dL; OR 18.8), older age (≥ 75 years; OR 4.7), bilateral diverticular location (OR 14.2) and chronic kidney disease (OR 5.6). The 1-year recurrence rate was 12.9%. We did not identify any independent risk factor for bleeding recurrence in this population.
  
  
  CONCLUSIONS
  In this series, nearly half of the patients hospitalized with diverticular bleeding presented with severe bleeding. Patients with low hemoglobin levels, older age, bilateral diverticular location and chronic kidney disease had a significantly increased risk for severe diverticular bleeding. In addition, a small number of patients rebled within the first year after the index episode, although we could not identify independent risk factors associated with the recurrence of diverticular bleeding.
authors.affiliation: Departamento de Ciências Biomédicas e de Medicina, Universidade do Algarve , Portugal.
authors.forename: Natércia
authors.initials: N
authors.lastname: Joaquim
authors.affiliation: Department of Gastroenterology, Centro Hospitalar do Algarve, Portugal.
authors.forename: Paulo
authors.initials: P
authors.lastname: Caldeira
authors.affiliation: Gastroenterology Department, Centro Hospitalar do Algarve, Portugal.
authors.forename: Artur G
authors.initials: AG
authors.lastname: Antunes
authors.affiliation: Gastroenterology Department, Centro Hospitalar do Algarve, Portugal.
authors.forename: Marta
authors.initials: M
authors.lastname: Eusébio
authors.affiliation: Department of Gastroenterology, Centro Hospitalar do Algarve, Portugal.
authors.forename: Horácio
authors.initials: H
authors.lastname: Guerreiro
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D043963:Diverticulosis, Colonic / Q000150:complications* / Q000453:epidemiology*; D004241:Diverticulum, Colon; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000453:epidemiology* / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011174:Portugal; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors