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Middle-term mortality and re-bleeding after initial diverticular bleeding: A nationwide study of 365 mostly elderly French patients.

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.

journal_name

United European Gastroenterol J

journal_title

United European gastroenterology journal

authors

Lorenzo D,Gallois C,Lahmek P,Lesgourgues B,Champion C,Charpignon C,Faroux R,Bour B,Remy AJ,Naouri C,Picon M,Poncin E,Macaigne G,Seyrig JA,Bernardini D,Bellaïche G,Grasset D,Henrion J,Heluwaert F,Piperaud R,Bordes

doi

10.1177/2050640616647816

subject

Has Abstract

pub_date

2017-02-01 00:00:00

pages

119-127

issue

1

eissn

2050-6406

issn

2050-6414

pii

10.1177_2050640616647816

journal_volume

5

pub_type

杂志文章

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