Impact of discontinuing non-steroidal antiinflammatory drugs on long-term recurrence in colonic diverticular bleeding

作     者：Naoyoshi Nagata Ryota Niikura Tomonori Aoki Takuro Shimbo Katsunori Sekine Hidetaka Okubo Kazuhiro Watanabe Toshiyuki Sakurai Chizu Yokoi Junichi Akiyama Mikio Yanase Masashi Mizokami Naomi Uemura 

作者机构：Department of Gastroenterology and HepatologyNational Center for Global Health and MedicineTokyo 162-8655Japan Department of Clinical Research and Informatics National Center for Global Health and MedicineTokyo 162-8655Japan Department of Gastroenterology and HepatologyNational Center for Global Health and MedicineKohnodai HospitalChiba 272-8516Japan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2015年第21卷第4期

页      面：1292-1298页

核心收录：

学科分类：1002[医学-临床医学] 10[医学] 

基　　金：Supported by A Grant-in-Aid for Research from the National Center for Global Health and Medicine No.26A-201 

主　　题：Non-steroidal anti-inflammatories Drug withdrawal 

摘      要：AIM: To determine the effect of discontinuing nonsteroidal antiinflammatory drugs(NSAIDs) on recurrence in long-term follow-up patients with colonic diverticular bleeding(CDB).METHODS: A cohort of 132 patients hospitalized for CDB examined by colonoscopy was prospectively enrolled. Comorbidities, lifestyle, and medications(NSAIDs, low-dose aspirin, antiplatelet agents, anticoagulants, acetaminophen, and corticosteroids) were assessed. After discharge, patients were requested to visit the hospital on scheduled days during the followup period. The Kaplan-Meier method was used to estimate recurrence.RESULTS: Median follow-up was 15 mo. The probability of recurrence at 1, 6, 12, and 24 mo was 3.1%, 19%, 27%, and 38%, respectively. Of the 41 NSAID users on admission, 26(63%) discontinued NSAID use at discharge. Many of the patients who could discontinue NSAIDs were intermittent users, and could be switched to alternative therapies, such as acetaminophen or an antiinflammatory analgesic plaster. The probability of recurrence at 12 mo was 9.4% in discontinuing NSAID users compared with 77% in continuing users(P 70 years, right-sided diverticula, history of hypertension, and hemodialysis. No patients developed cerebrocardiovascular events during follow-up.CONCLUSION: There is a substantial recurrence rate after discharge among patients hospitalized for diverticular bleeding. Discontinuation of NSAIDs is an effective preventive measure against recurrence. This study provides new information on risk reduction strategies for diverticular bleeding.