Gonai Takahiro, Toya Yosuke, Kudara Norihiko, Abe Keinosuke, Sawaguchi Sera, Fujiwara Takao, Eizuka Makoto, Miura Manami, Urushikubo Jun, Yamada Shun, Yamaguchi Satoko, Asakura Kensuke, Orikasa Shunsuke, Matsumoto Takayuki
Division of Gastroenterology, Department of Internal Medicine, School of Medicine, Iwate Medical University, Shiwa-gun, Japan.
Department of Gastroenterology, Iwate Prefectural Kuji Hospital, Kuji, Japan.
Scand J Gastroenterol. 2022 Jun;57(6):690-695. doi: 10.1080/00365521.2022.2035812. Epub 2022 Feb 9.
Few studies have evaluated risk factors for short-term re-bleeding in patients with colonic diverticular bleeding (CDB). We aimed to reveal risk factors for re-bleeding within a month in patients with CDB.
We retrospectively analyzed clinical course of patients with CDB diagnosed at 10 institutions between 2015 and 2019. Risk factors for re-bleeding within a month were assessed by Cox proportional hazards models.
Among 370 patients, 173 (47%) patients had been under the use of antithrombotic agents (ATs) and 34 (9%) experienced re-bleeding within a month. Multivariate analysis revealed that the use of ATs was an independent risk factor for re-bleeding within a month (HR 2.38, 95% CI 1.10-5.50, .028). Furthermore, use of multiple ATs and continuation of ATs were found to be independent risk factors for re-bleeding within a month (HR 3.88, 95% CI 1.49-10.00, .007 and HR 3.30, 95% CI 1.23-8.63, .019, respectively). Two of 370 patients, who discontinued ATs, developed thromboembolic event.
Use of ATs was an independent risk factor for short-term re-bleeding within a month in patients with CDB. This was especially the case for the use of multiple ATs and continuation of ATs. However, discontinuation of ATs may increase the thromboembolic events those patients.
很少有研究评估结肠憩室出血(CDB)患者短期再出血的危险因素。我们旨在揭示CDB患者1个月内再出血的危险因素。
我们回顾性分析了2015年至2019年间在10家机构诊断为CDB的患者的临床病程。通过Cox比例风险模型评估1个月内再出血的危险因素。
在370例患者中,173例(47%)患者一直在使用抗血栓药物(ATs),34例(9%)在1个月内发生再出血。多因素分析显示,使用ATs是1个月内再出血的独立危险因素(HR 2.38,95%CI 1.10-5.50,P = 0.028)。此外,发现使用多种ATs和继续使用ATs是1个月内再出血的独立危险因素(分别为HR 3.88,95%CI 1.49-10.00,P = 0.007和HR 3.30,95%CI 1.23-8.63,P = 0.019)。370例停用ATs的患者中有2例发生了血栓栓塞事件。
使用ATs是CDB患者1个月内短期再出血的独立危险因素。使用多种ATs和继续使用ATs的情况尤其如此。然而,停用ATs可能会增加这些患者的血栓栓塞事件。