NSAIDs are a significant risk factor for colonic diverticular hemorrhage in elder patients: Evaluation by a case-control study
NSAIDs are a significant risk factor for colonic diverticular hemorrhage in elder patients: Evaluation by a case-control study
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DOI：
10.1111/j.1440-1746.2010.06610.x
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发表时间：
2011-06-01
影响因子：
4.1
通讯作者：
Fujimoto, Kazuma
中科院分区：
文献类型：
--
作者：
Tsuruoka, Nanae;Iwakiri, Ryuichi;Fujimoto, Kazuma
背景与目的：憩室出血是下消化道出血的常见原因。一些因素，包括使用非甾体抗炎药（NSAIDs），抗血栓药物和动脉硬化，可能是危险因素。这项研究的目的是确定这些风险因素。方法：2000年1月至2008年12月，在佐贺医学院就诊的178例急性下消化道出血患者中，经急诊内镜检查和诊断标准，诊断为结肠憩室出血的患者有51例。从同期住院的其他疾病患者中选择性别和年龄相匹配的对照病例。我们通过logistic回归分析评估合并症的影响，如脑血管疾病、缺血性心脏病、高血压、高脂血症、糖尿病、慢性肾脏疾病和骨质疏松症、非甾体抗炎药和抗血栓药物、吸烟、饮酒和慢性便秘的习惯。结果178例急性下消化道出血患者中有51例（28.7%）诊断为憩室出血，憩室出血是下消化道出血最常见的原因。结肠憩室出血的男女性别比为35:16。非甾体抗炎药是老年患者结肠憩室出血的重要危险因素（优势比[OR] = 7.492, 95% CI: 1.516-37.024, P = 0.0135）。在65岁以下的患者中，高血压和高脂血症与憩室出血有显著相关性。本研究还表明，使用非甾体抗炎药是再出血的危险因素（OR = 5.4, 95% CI: 1.01-28.78, P = 0.048）。结论：本病例对照研究显示，使用非甾体抗炎药是老年患者结肠憩室出血的重要危险因素。此外，使用非甾体抗炎药是结肠憩室再出血的危险因素。
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 by using logistic regression analysis the influences of comorbidities such as cerebrovascular disease, ischemic heart disease, hypertension, hyperlipidemia, diabetes mellitus, chronic kidney disease, and osteoporosis, medications including NSAIDs and antithrombotic agents, and habits of smoking, alcohol, and chronic constipation.Results:Fifty one patients out of 178 acute lower gastrointestinal bleeding (28.7%) were diagnosed as 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 were a significant risk factor for colonic diverticular hemorrhage in elder patients (odds ratio [OR] = 7.492, 95% CI: 1.516-37.024, P = 0.0135). Hypertension and hyperlipidemia had significant association with diverticular hemorrhage among patients younger than 65 years old. This study also indicated that use of NSAIDs was a risk factor for re-bleeding (OR = 5.4, 95% CI: 1.01-28.78, P = 0.048).Conclusion:This case-control study revealed that the use of NSAIDs was a significant risk factor for colonic diverticular hemorrhage in elder patients. In addition, use of NSAIDs is a risk factor for re-bleeding from colonic diverticula.