Vajravelu RK, et al. - Using patients registered in the OptumInsight Clinformatics database from 2000 through 2016, a retrospective cohort study was conducted to investigate the frequency of and risk factors for recurrent diverticular hemorrhage. In addition, researchers ascertained if discontinuing anticoagulation after diverticular hemorrhage was correlated with ischemic stroke. Findings revealed that platelet aggregation inhibitors were correlated with recurrent diverticular hemorrhage, not anticoagulants. For ischemic stroke, discontinuing anticoagulation was correlated with increased hazard.

Methods

• For initial and recurrent diverticular hemorrhage, incidence rates were calculated by identifying subjects who had hospitalizations with a primary discharge diagnosis consistent with diverticular hemorrhage.
• Using Cox proportional hazards regression adjusted for demographics, comorbidities, and medication use, hazard ratios of second diverticular hemorrhage related to anticoagulants or platelet aggregation inhibitors were calculated.
• In patients who discontinued anticoagulation following diverticular hemorrhage, hazard ratio for ischemic stroke was calculated correspondingly.

Results

• The study results showed that initial diverticular hemorrhage was found in 14,925 patients; of these, 1,368 had a second episode.
• Findings revealed that the unstandardized incidence rates of initial and second diverticular hemorrhage were 10.9 per 100,000 person-years (95% CI, 10.7 – 11.0) and 3,625.6 per 100,000 person-years (95% CI, 3436.0 – 3823.0).
• It was noted that platelet aggregation inhibitors were associated with second episodes of diverticular hemorrhage (hazard ratio, 1.47; 95% CI, 1.15–1.88), while no correlation was seen with any classes of anticoagulation agents.
• According to the findings, among subjects with a potential indication for stroke prophylaxis, those who discontinued anticoagulation after the diverticular hemorrhage had an increased hazard of ischemic stroke (hazard ratio, 1.93; 95% CI, 1.17–3.19).