NSAIDs is a significant risk factor for colonic diverticular hemorrhage in elder patients: evaluation by a case-control study.
J Gastroenterol Hepatol. 2010 Dec 28;
Authors: Tsuruoka N, Iwakiri R, Hara M, Shirahama N, Sakata Y, Miyahara K, Eguchi Y, Shimoda R, Ogata S, Tsunada S, Sakata H, Fujimoto K
Background and Aim: Diverticular bleeding is a common cause of lower gastrointestinal hemorrhage. Several factors, including use of non-steroidal anti-inflammatory drugs (NSAIDs), antithrombotic agents and arteriosclerosis, could be risk factors. The aim of this study is to identify these risk factors. Methods: Between January 2000 and December 2008, 51 patients among 178 acute lower gastrointestinal hemorrhages who visited Saga Medical School were diagnosed as colonic diverticular hemorrhage established by emergency endoscopy and diagnostic criteria. Gender and age matched control cases were selected from patients of other diseases hospitalized during the same period. We evaluated influences of comorbidities such as cerebrovascular disease, ischemic heart disease, hypertension, hyperlipidemia, diabetes mellitus, chronic kidney disease, and osteoporosis, medications include NSAIDs and antithrombotic agents, and habits of smoking, alcohol, chronic constipation by using logistic regression analysis. Results: Fifty one patients out of 178 acute lower gastrointestinal bleeding (28.7%) were diverticular hemorrhage, which was the most common cause of lower gastrointestinal hemorrhage. Sex ratio of men versus women for colonic diverticular hemorrhage was 35:16. NSAIDs was significant risk factors for colonic diverticular hemorrhage in elder patients (OR=7.492, 95%CI: 1.516-37.024, p=0.0135). Hypertension and hyperlipidemia had significant association to diverticular hemorrhage among patients of younger than 65 years old. This study also indicated that use of NSAIDs was a risk factor for re-bleeding (odds ratio = 5.4, 95%CI: 1.01-28.78, p=0.048). Conclusion: This case-control study revealed that use of NSAIDs was significant risks factor for colonic diverticular hemorrhage in elder patients. In addition, NSAIDs is a risk factor for re-bleeding from colonic diverticula.
PMID: 21198829 [PubMed - as supplied by publisher]