Natural history of bleeding risk in colonic diverticulosis patients: a long‐term colonoscopy‐based cohort study. Issue 9 (26th February 2015)

• Record Type: Journal Article
• Authors: Niikura, R.; Nagata, N.; Shimbo, T.; Aoki, T.; Yamada, A.; Hirata, Y.; Sekine, K.; Okubo, H.; Watanabe, K.; Sakurai, T.; Yokoi, C.; Mizokami, M.; Yanase, M.; Akiyama, J.; Koike, K.; Uemura, N.
• Is Part Of: Alimentary pharmacology & therapeutics. Volume 41:Issue 9(2015)
• Page Start: 888
• Page End: 894
• Publication Date: 2015-02-26
• Subjects: Digestive organs -- Diseases -- Treatment -- Periodicals; Digestive organs -- Effect of drugs on -- Periodicals; Gastrointestinal system -- Diseases -- Treatment -- Periodicals; Gastrointestinal system -- Effect of drugs on -- Periodicals; 615.73
• DOI: 10.1111/apt.13148
• Languages: English
• ISSNs: 0269-2813

Abstract

<abstract abstract-type="main" id="apt13148-abs-0001"> <title>Summary</title> <sec id="apt13148-sec-0001" sec-type="section"> <title>Background</title> <p>The natural history of bleeding risk from colonic diverticulosis remains unclear.</p> </sec> <sec id="apt13148-sec-0002" sec-type="section"> <title>Aim</title> <p>To identify the incidence of bleeding in colonic diverticulosis patients and associated risk factors.</p> </sec> <sec id="apt13148-sec-0003" sec-type="section"> <title>Methods</title> <p>A cohort of 1514 patients with colonoscopy‐confirmed asymptomatic diverticulosis was selected between 2001 and 2013. Age, sex and location of colonic diverticulosis (right or left side, or bilateral) were assessed. The endpoint was a bleeding event, and data were censored at the time of last colonoscopy. The cumulative and overall incidences of bleeding were estimated using the Kaplan–Meier and person‐years methods. The Cox proportional hazards model was used to estimate age‐ and sex‐adjusted hazard ratios (aHRs).</p> </sec> <sec id="apt13148-sec-0004" sec-type="section"> <title>Results</title> <p>The median follow‐up period was 46 months. Bleeding events occurred in 35 patients, and the median time‐to‐event interval was 50 months. Kaplan–Meier analysis showed that the cumulative incidence of diverticular bleeding was 0.21% at 12 months, 2.2% at 60 months and 9.5% at 120 months. By the person‐years method, the overall incidence rate of bleeding was 0.46 per 1000 patient‐years. On multivariate analysis, age ≥70 (aHR. 3.7) and bilateral diverticulosis (aHR, 2.4) were significant risk factors for bleeding.</p> </sec> <sec id="apt13148-sec-0005" sec-type="section"> <title>Conclusions</title> <p>This long‐term follow‐up study demonstrated that the cumulative incidence of bleeding from diverticulosis was approximately 2% at 5 years and 10% at 10 years, and the overall incidence was 0.46 per 1000 patient‐years. Bilateral diverticulosis increased the risk of bleeding.</p> </sec> </abstract>