Document Detail


Risk factors predictive of severe diverticular hemorrhage.
MedLine Citation:
PMID:  20937418     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Diverticular disease is a common cause for lower gastrointestinal bleeding. Although the hemorrhage often resolves spontaneously, some patients will require massive transfusions and emergency surgery. In this study we report risk factors predictive of severe diverticular bleeds.
METHODS: We completed a retrospective analysis of 99 patients, admitted with lower gastrointestinal bleeding and colonoscopic evidence of diverticulosis and no other cause of the hemorrhage between January 1995 and December 2005. A database was generated and univariate and multivariate analyses were carried out.
RESULTS: Of the 99 patients, 23 patients were classified as having a severe bleed defined as having a systolic blood pressure below 90 mm Hg, requirement for more than 6 units of transfusion, or emergent surgery. Multiple logistic regression showed that the initial hemoglobin (p = 0.001), INR ≥ 1.5 (p = 0.003), initial diastolic blood pressure (p = 0.024), initial heart rate (p = 0.047), and blood pressure medications (p = 0.049) predicted severe diverticular hemorrhage.
CONCLUSIONS: The identified predictor variables are all quantifiable at the time of initial presentation, and these may help identify severe cases of diverticular bleeding requiring urgent management.
Authors:
Kathy K Lee; Syed M Shah; Michael A Moser
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2010-10-14
Journal Detail:
Title:  International journal of surgery (London, England)     Volume:  9     ISSN:  1743-9159     ISO Abbreviation:  Int J Surg     Publication Date:  2011  
Date Detail:
Created Date:  2011-01-14     Completed Date:  2011-06-28     Revised Date:  2011-07-12    
Medline Journal Info:
Nlm Unique ID:  101228232     Medline TA:  Int J Surg     Country:  England    
Other Details:
Languages:  eng     Pagination:  83-5     Citation Subset:  IM    
Copyright Information:
Copyright © 2010 Surgical Associates Ltd. All rights reserved.
Affiliation:
Department of Surgery, University of Calgary, Tom Baker Cancer Center, Education Office TBCC110D, 1331 - 29 St. NW, Calgary, AB, Canada, T2N 4N2. kathyk.lee@albertahealthservices.ca
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cohort Studies
Colonic Diseases / complications*,  diagnosis*,  therapy
Colonoscopy
Diverticulum / complications*,  diagnosis*,  therapy
Female
Gastrointestinal Hemorrhage / diagnosis,  etiology*,  therapy
Humans
Male
Middle Aged
Predictive Value of Tests
Retrospective Studies
Risk Factors
Comments/Corrections
Comment In:
Int J Surg. 2011;9(4):353-4   [PMID:  21296690 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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