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Cirrhosis Is Associated with Increased Mortality in Patients with Diverticulitis: A Nationwide Cross-Sectional Study

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Abstract

Background

Diverticulitis in patients with cirrhosis has been associated with higher surgical mortality, but no prior studies evaluate non-surgical treatment results.

Aims

Our aim was to compare the outcomes of hospitalization for diverticulitis in patients with and without cirrhosis.

Methods

We utilized the Nationwide Inpatient Sample (2007–2013) for patients with and without cirrhosis hospitalized for diverticulitis. Patients were further stratified by the presence of compensated versus decompensated cirrhosis. Validated ICD-9 codes captured patients and surgical procedures. Multivariate logistic regression models were fit. The primary outcomes of interest were mortality and surgical intervention rates.

Results

There were 1,555,469 patients hospitalized for diverticulitis without cirrhosis, and 7523 patients hospitalized for diverticulitis with cirrhosis. On multivariate analysis, patients with cirrhosis had an increased mortality rate (OR 2.28; 95% CI 1.48–3.5). There were no significant differences in surgical interventions. Subgroup multivariate analyses of compensated cirrhosis (n = 6170) and decompensated cirrhosis (n = 1353) revealed that decompensated cirrhosis had an increased mortality rate (OR 4.99; 95% CI 2.48–10.03) when compared to patients without cirrhosis, whereas those with compensated cirrhosis did not (OR 1.67; 95% CI 0.96–2.91). Those with compensated cirrhosis underwent less surgical interventions (OR 0.82; 95% CI 0.67–0.99) compared to those without cirrhosis. Patients with diverticulitis and cirrhosis had increased costs and lengths of hospitalization.

Conclusion

Presence of cirrhosis in patients hospitalized for diverticulitis is associated with an increased mortality rate. These are novel findings, and future clinical studies should focus on improving diverticulitis outcomes in this group.

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Authors and Affiliations

  1. Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA

    Andrew J. Kruger & Rohan M. Modi

  2. Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W 12th Ave, Suite 200, Columbus, OH, 43210, USA

    Khalid Mumtaz, Ahmad Anaizi, Hisham Hussan, Cheng Zhang, Alice Hinton, Darwin L. Conwell, Somashekar G. Krishna & Peter P. Stanich

  3. Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA

    Alice Hinton

Authors
  1. Andrew J. Kruger
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  2. Khalid Mumtaz
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  3. Ahmad Anaizi
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  4. Rohan M. Modi
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  5. Hisham Hussan
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  6. Cheng Zhang
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  7. Alice Hinton
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  8. Darwin L. Conwell
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  9. Somashekar G. Krishna
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  10. Peter P. Stanich
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Contributions

All authors contributed significantly to this manuscript.

Corresponding author

Correspondence to Peter P. Stanich.

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The authors have neither relevant conflicts of interest nor financial interest to disclose.

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Kruger, A.J., Mumtaz, K., Anaizi, A. et al. Cirrhosis Is Associated with Increased Mortality in Patients with Diverticulitis: A Nationwide Cross-Sectional Study. Dig Dis Sci 62, 3149–3155 (2017). https://doi.org/10.1007/s10620-017-4782-9

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  • DOI: https://doi.org/10.1007/s10620-017-4782-9

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