High Charlson comorbidity index scores are associated with recurrent colon diverticular bleeding

Abstract Background/Aims: Colonic diverticular bleeding (CDB) is a common cause of acute lower gastrointestinal bleeding. Patients with CDB are at increased risk for recurrence. Here, we aimed to evaluate the clinical course of patients with CDB and identify risk factors, including the Charlson comorbidity index (CCI), for recurrent CDB (rCDB).Methods: We retrospectively included patients who were hospitalized at the Chonnam National University Hospital for management of CDB between January 2005 and March 2020, and data on the underlying disease, drug history, treatment method, post-discharge rCDB, and death were checked.Results: Among 221 investigated patients (mean age, 68.1 years; 56 females), 56 and 165 had definite and presumptive CDB, respectively, 122 (55.2%) had a right-sided CDB, and 51 (23.3%) experienced rCDB throughout a median period of 339 days (range, 3–4817 days). The most common comorbidities were hypertension (62.4%) and diabetes (33.5%). The median length of hospitalization was 5 days (range, 2–119 days). The CDB-related morality rate was 0.9% at first admission. The cumulative incidence rates of rCDB after 1, 6, 12, 24 months were 4.6%, 9.1%, 12.3%, and 16.9%, respectively. In Cox regression analysis, rCDB more frequently occurred in patients with CCI ≥ 4 than in patients with CCI < 4 (adjusted hazard ratio, 2.76; 95% confidence interval, 1.30–5.88; p < 0.01).Conclusions: rCDB occurred frequently at any time in patients with previous CDB. High CCI scores were associated with rCDB. Clinicians need to consider possible rCDB for patients with high CCIs.