Research Day
DOES A COLONOSCOPY NEED TO BE DONE NOW?: QUANTITATING THE VALUE OF CLINICAL HISTORY IN DIAGNOSING DIVERTICULAR HEMORRHAGE
Document Type
Abstract
Date
2021
Abstract
Background: Diverticulosis is one of the most common conditions worldwide. Absent in the literature is work evaluating the contribution of clinical history in diagnosing diverticular hemorrhage.
Study Aim: To evaluate the diagnostic value of a characteristic diverticular bleed history (painless bright red blood per rectum with a past medical history of diverticular disease) in diagnosing diverticular hemorrhage among patients presenting with acute lower gastrointestinal bleed (LGB) without high-risk features.
Methods: This pilot retrospective cohort study was conducted at a Midwest community teaching hospital. Data collected from the electronic medical record involved adult patients presenting with acute LGB between 2003 and 2019. Inclusion criteria included vital stability and the absence of high-risk features. Patients were evaluated for the presence of a positive diverticular bleed history. Statistical analysis included a chi-squared analysis, sensitivity/specificity, positive predictive value(ppv), and negative predictive value(npv).
Results: 116 consecutive cases with a mean age of 67.7 were included with a diverticular hemorrhage prevalence of 24.2% (28/116 cases) by endoscopy. A positive history was significantly associated with an endoscopic diagnosis of diverticular hemorrhage with an effect size of 0.528.