High Cost of Hospitalization for Colonic Diverticular Bleeding Depended on Repeated Bleeding and Blood Transfusion: Analysis with Diagnosis Procedure Combination Data in Japan

Ito, Yoichiro; Sakata, Yasuhisa; Yoshida, Haruhiko; Nonaka, Sayuri; Fujii, Susumu; Tanaka, Yuichiro; Shirai, Shimpei; Takeshita, Eri; Akutagawa, Takashi; Kawakubo, Hiroharu; Yamamoto, Kōji; Tsuruoka, Nanae; Shimoda, Ryo; Iwakiri, Ryuichi; Fujimoto, Kazuma

doi:10.1159/000478256

Cited by 22 publications

(18 citation statements)

References 24 publications

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“…Diverticular bleeding can be massive and recurs frequently; therefore, it involves repeated examination, hospitalization, and blood transfusion. In Asia, based on the diagnosis procedure combination data, Ito et al [68] reported that rebleeding and blood transfusion were related to high cost of hospitalization for colonic diverticular bleeding. Assertive endoscopic hemostasis might decrease the cost of hospitalization in patients with colonic diverticular rebleeding.…”

Section: Burden Of Diverticular Diseasementioning

confidence: 99%

The Burden of Diverticular Disease and Its Complications: West versus East

Imaeda¹,

Hibi²

2018

Inflamm Intest Dis

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Background: Colonic diverticulosis is prevalent and increasing not only in Western but also in Asian countries. Diverticulosis can be complicated by diverticulitis and diverticular bleeding. Diverticular disease is a burdensome digestive disease, because it is a major cause of hospital admissions and is associated with significant health-care costs. Summary: The incidence of diverticulosis increases with age. Most cases of diverticulosis in Western countries involve the left side of the colon, while diverticulosis is predominantly present on the right side of the colon in Asian countries. The incidence of diverticulitis also increases with age. Diverticulitis is predominantly located on the left side of the colon in Western countries, while it is predominantly located on the right side of the colon in Asian countries. The overall complication rate is higher in left-sided than in right-sided diverticulitis. The incidence of diverticular bleeding also increases with age. The right colon is the source of diverticular bleeding in more than 50% of patients in Western countries. In Asian countries, age greater than 70 years and both-sided diverticulosis increase the bleeding risk. Key Messages: In Western countries, diverticulosis and diverticulitis are predominantly located on the left side of the colon, whereas they are predominantly present on the right side of the colon in Asian countries. Diverticular bleeding is predominantly located on the right side in Western countries, and both-sided diverticulosis increases the risk of bleeding in Asian countries. Diverticular disease with complications requires admission and operation; moreover, it recurs frequently. Therefore, diverticular disease is associated with a significant economic burden in terms of health-care costs and resource utilization.

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Section: Burden Of Diverticular Diseasementioning

confidence: 99%

The Burden of Diverticular Disease and Its Complications: West versus East

Imaeda¹,

Hibi²

2018

Inflamm Intest Dis

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“…In the United States, diverticular disease was the fifth most common reason for ambulatory care visits in 2004 [1]. Diverticulosis of the colon is an important cause of hospital admissions and a significant contributor to healthcare costs in Japan and the United States [1,14,15]. Moreover, diverticular disease is a recurrent disease burden in many patients [16].…”

Section: Doi: 101159/000491875mentioning

confidence: 99%

Distinct Clinical Factors in Hospitalized Patients with Diverticular Bleeding and Diverticulitis

et al. 2018

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Background/Aims: It is unclear why colonic diverticular bleeding and diverticulitis rarely coexist. This study compared the characteristics of these conditions. Methods: This single-center retrospective study examined 310 consecutive patients hospitalized with an episode of diverticular disease (cases) and outpatients without a diverticular episode (controls) from January 2012 to December 2015. We investigated distinct clinical factors in hospitalized patients with diverticular bleeding and diverticulitis. Results: We identified 183 patients with 263 episodes of diverticular bleeding and 127 patients with 135 episodes of diverticulitis during the study period. Patients with diverticular bleeding were significantly older than those with diverticulitis (median age 76 vs. 56 years) and had more cardiovascular disease, hypertension, diabetes, cerebrovascular disease, chronic kidney disease, lipid disorder, or a poorer performance status. Significantly more diverticular bleeding patients were taking antiplatelet drugs, anticoagulant drugs, proton pump inhibitors, or laxative agents. Multivariate analysis revealed that an age > 65 years (OR 5.42), and antiplatelet agent use (OR 7.29) were more significant risk factors for diverticular bleeding than for diverticulitis. Conclusions: Elderly people using antiplatelet drugs may be more susceptible to diverticular bleeding than diverticulitis.

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“…A significant percentage of patients with CDB develop severe bleeding, necessitating prolonged hospitalization. Prolonged hospitalization causes deterioration in patients' quality of life, as well as difficulties with cost‐effective utilization of medical resources, and is a financial burden to the society . Therefore, we investigated the factors associated with the length of hospitalization to ensure optimal management of hospitalized patients.…”

Section: Introductionmentioning

confidence: 99%

“…Prolonged hospitalization causes deterioration in patients' quality of life, as well as difficulties with cost-effective utilization of medical resources, and is a financial burden to the society. [25][26][27][28][29][30] Therefore, we investigated the factors associated with the length of hospitalization to ensure optimal management of hospitalized patients. CDB between July 2008 and February 2016.…”

Section: Introductionmentioning

confidence: 99%

Colonic diverticular bleeding and predictors of the length of hospitalization: An observational study

Wada

Nishizawa

Kato

et al. 2019

J of Gastro and Hepatol

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Background and Aim A significant percentage of patients with colonic diverticular bleeding (CDB) experience bleeding that is severe enough to necessitate prolonged hospitalization. Prolonged hospitalization causes deterioration in patients' quality of life, as well as difficulties with cost‐effective utilization of medical resources, and is a financial burden to the society. Therefore, we investigated the factors associated with the length of hospitalization for the optimal management of patients hospitalized with CDB. Methods This study included patients who were hospitalized for the treatment of CDB and underwent colonoscopy between July 2008 and February 2016. Logistic regression analysis was performed to investigate the association between the length of hospitalization and the patients' baseline characteristics, in‐hospital procedures performed, and the clinical outcomes. Results The study included 223 patients. Diabetes mellitus (odds ratio [OR] 3.4, P = 0.014) and blood transfusion (OR 3.1, P = 0.0006) were identified as risk factors for prolonged hospitalization (≥ 8 days). Urgent colonoscopy (OR 0.41, P = 0.0072) predicted a shorter length of hospitalization (≤ 7 days). The study also indicated that endoscopic treatment showed a stronger association with urgent colonoscopy (OR 7.8, P < 0.0001) than with elective colonoscopy and that urgent colonoscopy was not associated with an increased rate of adverse events or re‐bleeding. Conclusions Compared with elective colonoscopy, urgent colonoscopy shortens the length of hospitalization in patients with CDB. Moreover, it is not associated with an increased rate of adverse events. Urgent colonoscopy may be impracticable in a few cases; however, if possible, aggressive urgent colonoscopy should be considered for the efficient management of the patient's hospital stay.

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High Cost of Hospitalization for Colonic Diverticular Bleeding Depended on Repeated Bleeding and Blood Transfusion: Analysis with Diagnosis Procedure Combination Data in Japan

Cited by 22 publications

References 24 publications

The Burden of Diverticular Disease and Its Complications: West versus East

The Burden of Diverticular Disease and Its Complications: West versus East

Distinct Clinical Factors in Hospitalized Patients with Diverticular Bleeding and Diverticulitis

Colonic diverticular bleeding and predictors of the length of hospitalization: An observational study

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