Association between timing for colonoscopy and clinical outcomes in patients with colonic diverticular bleeding: a multicenter retrospective study

Abstract Purpose Clinical benefits of early colonoscopy (ECS) for colonic diverticular bleeding (CDB) remain controversial. This study aimed to investigate the association between timing for colonoscopy and clinical outcomes in patients with CDB. Methods This was a secondary analysis of a multicenter retrospective study. The study included patients hospitalized for CDB at 10 institutions between January 2015 and August 2019. ECS was defined as colonoscopy performed within 24 h of admission, and delayed colonoscopy (DCS) as thereafter. Clinical characteristics, colonoscopic findings, and outcomes were compared between the ECS and DCS groups. Results Among 356 patients, 242 patients underwent ECS and 114 patients underwent DCS. Overall, stigmata of recent hemorrhage (SRH) were identified in 111 (31.2%) patients and endoscopic hemostasis was applied to 87 patients, and re-bleeding within a month occurred in 9.0%. The detection rate of SRH was higher ( P = 0.008) and endoscopic hemostasis was applied more frequently ( P = 0.034) in the ECS group than in the DCS group. Re-bleeding occurred more frequently in the ECS group than in the DCS group ( P = 0.002). Multivariable analysis demonstrated that antithrombotic therapy (hazard ratio [HR], 2.80; 95% confidence interval [CI], 1.22–7.01; P = 0.014) and ECS (HR, 4.85; 95% CI, 1.72–20.31; P = 0.002) were independently associated with re-bleeding. Conclusion ECS was independently associated with re-bleeding within a month in patients with CDB, suggesting the importance of appropriate patient selection for ECS.