Open AccessRisk factor analysis for early rebleeding after endoscopic treatment for colonic diverticular bleeding with stigmata of recent hemorrhage
Author(s) -
Yamauchi Atsushi,
Kou Tadayuki,
Kishimoto Takuya,
Mori Yuki,
Osawa Kazuki,
Iimori Kei,
Iwano Kosuke,
Kawai Yuya,
Sawada Kenji,
Hamada Kensuke,
Nishimura Satoshi,
Mori Yoshiharu,
Watanabe Kotaro,
Azuma Shunjiro,
Morita Toshihiro,
Kurita Akira,
Kawaguchi Kiyotaka,
Suginoshita Yoshiki,
Katayama Toshiro,
Yazumi Shujiro
Publication year - 2021
Publication title -
jgh open
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.546
H-Index - 8
ISSN - 2397-9070
DOI - 10.1002/jgh3.12535
Subject(s) - medicine , odds ratio , surgery , clipping (morphology) , univariate analysis , risk factor , endoscopic treatment , gastroenterology , logistic regression , hemostasis , endoscopy , multivariate analysis , philosophy , linguistics
Background and Aim Colonic diverticular bleeding is a common cause of acute lower gastrointestinal bleeding. Endoscopic hemostasis is generally selected as the first‐line treatment; however, a considerable number of patients experience early rebleeding after endoscopic treatment. We investigated the risk factors for early rebleeding after endoscopic treatment. Methods We retrospectively evaluated the data of 142 consecutive patients who underwent endoscopic treatment (endoscopic clipping or endoscopic band ligation) for colonic diverticular bleeding with stigmata of recent hemorrhage between April 2012 and April 2020. Multivariate logistic regression analysis was conducted to evaluate the statistical relationship between patient characteristics and the incidence of early rebleeding occurring within 30 days after endoscopic treatment. Results Of 142 patients, early rebleeding was detected in 34 (23.9%) patients. According to univariate analysis, platelet count of <10 × 10 4 /μL, bleeding from the left‐sided colon, and endoscopic clipping usage were associated with early rebleeding ( P < 0.05). The subsequent multivariate logistic regression analysis identified bleeding from the left‐sided colon (odds ratio [OR], 4.16; 95% confidence interval [CI], 1.73–10.0; P = 0.001) and endoscopic clipping usage (OR, 2.92; 95% CI, 1.21–7.00; P = 0.017) as the independent risk factors for early rebleeding. Conclusions Bleeding from the left‐sided colon and endoscopic clipping usage were the risk factors for early rebleeding after endoscopic treatment. Using endoscopic band ligation was associated with a decreased risk for early rebleeding compared with the use of endoscopic clipping, indicating that endoscopic band ligation was a preferable endoscopic modality to prevent early recurrent bleeding.