Middle-term mortality and re-bleeding after initial diverticular bleeding: A nationwide study of 365 mostly elderly French patients. Issue 1 (February 2017)

• Record Type: Journal Article
• Authors: Lorenzo, Diane; Gallois, Claire; Lahmek, Pierre; Lesgourgues, Bruno; Champion, Christine; Charpignon, Claire; Faroux, Roger; Bour, Bruno; Remy, André-Jean; Naouri, Chantal; Picon, Magali; Poncin, Eric; Macaigne, Gilles; Seyrig, Jacques-Arnaud; Bernardini, David; Bellaïche, Guy; Grasset, Denis; Henrion, Jean; Heluwaert, Frédéric; Piperaud, René; Bordes, Gilbert; Bourhis, Francois; Arpurt, Jean-Pierre; Pariente, Alexandre; Nahon, Stéphane
• Is Part Of: United European Gastroenterology journal. Volume 5:Issue 1(2017)
• Page Start: 119
• Page End: 127
• Publication Date: 2017-02
• Subjects: Aging -- antiplatelet therapy -- anticoagulant therapy -- bleeding -- diverticular bleeding -- gastrointestinal bleeding -- lower intestine -- mortality -- risk factors; Gastroenterology -- Periodicals; Periodicals; 616.33005
• DOI: 10.1177/2050640616647816
• Languages: English
• ISSNs: 2050-6406

Abstract

Background and aims: The aim of this study was to determine the mortality and re-bleeding rates, and the risk factors involved, in a cohort of patients with previous diverticular bleeding (DB). Methods: In 2007, data on 2462 patients with lower gastrointestinal (GI) bleeding were collected prospectively at several French hospitals. We studied the follow-up of patients with DB retrospectively. The following data were collected: age, mortality rates and re-bleeding rates, drug intake, surgery and comorbidities. Results: Data on 365 patients, including 181 women (mean age 83.6 ± 9.8 years) were available. The median follow-up time was 3.9 years (IQR 25–75: 1.7–5.4). Of these, 148 patients died (40.5%). Among the 70 patients (19.2%) who had at least one re-bleeding episode, nine died and three underwent surgical procedures. Anticoagulation and antiplatelet therapy was discontinued in 70 cases (19.2%). The independent risk factors contributing to mortality were age > 80 years (HR = 3.18 (2.1–4.9); p < 0.001) and a Charlson comorbidity score > 2 (1.91 (1.31–2.79); p = 0.003). Discontinuation of therapy was not significantly associated with a risk of death due to cardiovascular events. No risk factors responsible for re-bleeding were identified, such as antiplatelet and anticoagulant therapy in particular. Conclusions: In this cohort, the rates of mortality and DB re-bleeding after a median follow-up time of 3.9 years were 19.2% and 40.5%, respectively. The majority of the deaths recorded were not due to re-bleeding.