Investigation of risk factors predicting recurrence of colonic diverticular hemor- rhage and development of a recurrence risk score

Aim : Colonic diverticular hemorrhage often recurs. Several studies have identified risk factors for recurrence, but to our knowledge, none have focused on risk factors in the clinical situa- tion. The present study aimed to identify risk factors for the recur- rence of hemorrhage and to create a recurrence risk score. Method: Hospitalized patients diagnosed with diverticular bleeding from 2008 to 2013 (N = 151) were included in a retrospec- tive cohort study. Risk factors predicting re-bleeding were identi- fied using multivariate analysis, and a risk score was developed using receiver operator characteristic (ROC) analysis. Results : Recurrence was identified in 52 patients (34.4%) at a median interval of 11.5 months. A history of hypertension and hy- perlipidemia, a faster heart rate on admission, and longer hospital- ization period were significant risk factors for re-bleeding. We de- veloped a re-bleeding risk score by using these 4 factors ; the area under the curve of ROC curve was 0.8. With this risk score, if the cut-off point is 7, then the sensitivity is very high (94% ; specificity : 26%) ; if the cutoff point is 14, the specificity is very high (97% ; sensitivity : 40%). This enables the division of patients into 3 groups : high risk, intermediate risk, and low risk. Conclusion : Colonic diverticular hemorrhage often recurs, and patients have high recurrence rates within short periods. Risk factors for re-bleeding include a history of hypertension and hyper- lipidemia, faster heart rate, and longer hospitalization period, and the risk score may supply useful information for clinicians to aid management. (Acta gastroenterol. belg., 2014, 77, 408-412).