Does High Charlson comorbidity index scores predict recurrence of colon diverticular bleeding?

Aims Recurrent bleeding is a frequent and serious complication in patients with colonic diverticular disease (CDB), often leading to multiple hospitalizations and increased healthcare costs. Identifying reliable predictors for rebleeding risk is crucial for improving patient management and outcomes. The Charlson Comorbidity Index (CCI), a well-established tool for evaluating comorbidity burden, may offer valuable insights into a patient’s overall health status by quantifying the impact of coexisting conditions on mortality and morbidity. This study aims to assess the accuracy of the CCI as a predictive marker for rebleeding in patients with colonic diverticular disease.

Methods This retrospective study was conducted from January 2022 to October 2024 at a tertiary university hospital, including all patients hospitalized for colonic diverticular bleeding. Collected data included patient demographics, comorbidities, medication history, treatment strategies, and post-discharge outcomes. The CCI was calculated for each patient to determine comorbidity burden, assigning weighted scores based on the severity of various conditions and their association with one-year mortality. The total CCI score was used to evaluate its correlation with rebleeding risk in colonic diverticular disease.

Results Among the 109 patients studied, 54.1% (n=59) had definite or presumptive CDB, with a predominance of male patients (n=42, sex ratio=1.47) and a median age of 71.8 years (range, 52–89). Right-sided CDB was observed in 64.4% of cases, and 47.5% experienced recurrent CDB during a median follow-up of 350 days (range, 5–538 days). Hypertension was the most common comorbidity (59.3%), followed by diabetes (47.5%). The median length of hospitalization was 5 days (range, 2–21 days). The CDB-related mortality rate at the first admission was 1.8%. The cumulative incidence rates of recurrent CDB (rCDB) at 1, 6, 12, and 24 months were 1.8%, 2.8%, 4.6%, and 6.4%, respectively. In Cox regression analysis, a CCI score of ≥ 4 was significantly associated with an increased risk of rCDB, and an adjusted hazard ratio of 2.58 (95% confidence interval, 1.38–5.78; p<0.01).

Conclusions The Charlson Comorbidity Index is a valuable predictor of recurrent colonic diverticular bleeding. Patients with a higher CCI score, indicating a greater burden of comorbidities, are at a significantly higher risk for rebleeding. Incorporating the CCI into clinical practice can help identify high-risk patients and guide personalized management strategies.

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Artikel online veröffentlicht:
27. März 2025