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Trends in hospital admission for acute diverticulitis in Italy from 2008 to 2015

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Abstract

Background

Epidemiological studies in Western countries have documented an increase of hospitalizations for acute diverticulitis (AD) but Italian evidence is scarce. The aim of the present study was to analyse the trend in hospitalization for AD, including in-hospital mortality, in Italy from 2008 to 2015.

Methods

Through the Italian Hospital Information System of the National Health System, we identified diverticulitis of the colon as a discharge diagnosis. Age- and gender-specific rates of hospitalization for AD were assessed.

Results

174,436 hospitalizations were identified with an increasing rate in 2008–2015 from 39 to 48 per 100,000 inhabitants (p < 0.001). The rate of hospitalization was higher for women, but the increasing trend over time was even more pronounced among men (mean increase per year 3.9% and 2.1% among men and women, respectively) (p < 0.001). The increased rate of hospitalization was accounted for by patients less than 70 years old, especially those under 60. In contrast, the hospitalization rate for older patients (age ≥ 70 years) was higher but remained unchanged during the study period. The number of patients with one hospital admissions was significantly higher than the number of patients with at least two hospitalizations (p < 0.001) and both groups showed a significant and comparable increase year by year. The overall in-hospital mortality rate increased from 1.2 to 1.5% (p = 0.017). More specifically, the increase was observed in patients at their first hospitalization [from 1 to 1.4% (mean increase per year of 3%, p = 0.003)]. An increase in mortality was most evident among women (from 1.4 to 1.8% p = 0.025) and in older patients [age 70–79 years from 1.2 to 1.7% (p = 0.034), ≥ 80 years from 2.9 to 4% (p = 0.001)].

Conclusions

In Italy, between 2008 and 2015, the rate of hospitalization for AD has been constantly increasing due to the hospitalization of younger individuals, especially men. There was a significant increase of in-hospital mortality especially among women, elderly and during the first hospitalization. These findings suggest the need for increased awareness and clinical skills in the management of this common condition.

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References

  1. Stollman N, Raskin JB (2004) Diverticular disease of the colon. Lancet 363:631–639

    Article  PubMed  Google Scholar 

  2. Shahedi K, Fuller G, Bolus R et al (2013) Long-term risk of acute diverticulitis among patients with incidental diverticulosis found during colonoscopy. Clin Gastroenterol Hepatol 11:1609–1613

    Article  PubMed  PubMed Central  Google Scholar 

  3. Peery AF, Dellon ES, Lund J et al (2012) Burden of gastrointestinal disease in the United States: 2012 update. Gastroenterology 143:1179–1187

    Article  PubMed  Google Scholar 

  4. Kang JY, Hoare J, Tinto A et al (2003) Diverticular disease of the colon—on the rise: a study of hospital admissions in England between 1989/1990 and 1999/2000. Aliment Pharmacol Ther 17:1189–1195

    Article  CAS  PubMed  Google Scholar 

  5. Jeyarajah S, Papagrigoriadis S (2008) Diverticular disease increases and effects younger ages: an epidemiological study of 10-year trends. Int J Colorectal Dis 23:619–627

    Article  PubMed  Google Scholar 

  6. Etzioni DA, Mack TM, Beart RW Jr, Kaiser AM (2009) Diverticulitis in the United States: 1998–2005: changing patterns of disease and treatment. Ann Surg 249:210–217

    Article  PubMed  Google Scholar 

  7. Nguyen GC, Sam J, Anand N (2011) Epidemiological trends and geographic variation in hospital admissions for diverticulitis in the United States. World J Gastroenterol 17:1600–1605

    Article  PubMed  PubMed Central  Google Scholar 

  8. Paterson HM, Arnott ID, Nicholls RJ et al (2015) Diverticular disease in Scotland: 2000–2010. Colorectal Dis 17:329–334

    Article  CAS  PubMed  Google Scholar 

  9. Wheat CL, Strate LL (2016) Trends in hospitalization for diverticulitis and diverticular bleeding in the United States from 2000 to 2010. Clin Gastroenterol Hepatol 14:96–103

    Article  PubMed  Google Scholar 

  10. Talabani A, Lydersen S, Endreseth BH, Edna TH (2014) Major increase in admission- and incidence rates of acute colonic diverticulitis. Int J Colorectal Dis 29:937–945

    Article  Google Scholar 

  11. Bharucha AE, Parthasarathy G, Ditah I et al (2015) Temporal trends in the incidence and natural history of diverticulitis: a population-based study. Am J Gastroenterol 110:1589–1596

    Article  PubMed  PubMed Central  Google Scholar 

  12. Cuomo R, Barbara G, Pace F et al (2014) Italian consensus conference for colonic diverticulosis and diverticular disease. United Eur Gastroenterol J 2:413–442

    Article  Google Scholar 

  13. Binda GA, Cuomo R, Laghi A et al (2015) Italian Society of Colon and Rectal Surgery. Practice parameters for the treatment of colonic diverticular disease: Italian Society of Colon and Rectal Surgery (SICCR) guidelines. Tech Coloproctol 19:615–626

    Article  CAS  PubMed  Google Scholar 

  14. StataCorp (2013) Stata statistical software: release 13. StataCorp LP, College Station

    Google Scholar 

  15. Masoomi H, Buchberg B, Nguyen B, Tung V, Stamos MJ, Mills S (2011) Outcomes of laparoscopic versus open colectomy in elective surgery for diverticulitis. World J Surg 35:2143–2148

    Article  PubMed  Google Scholar 

  16. Simianu VV, Fichera A, Bastawrous AL et al (2016) Number of diverticulitis episodes before resection and factors associated with earlier interventions. JAMA Surg 151:604–610

    Article  PubMed  PubMed Central  Google Scholar 

  17. Vather R, Broad JB, Jaung R, Robertson J, Bissett IP (2015) Demographics and trends in the acute presentation of diverticular disease: a national study. ANZ J Surg 85:744–748

    Article  PubMed  Google Scholar 

  18. Bollom A, Austrie J, Hirsch W et al (2017) Emergency Department burden of diverticulitis in the USA, 2006–2013. Dig Dis Sci 62:2694–2703

    Article  PubMed  PubMed Central  Google Scholar 

  19. Kyle J, Adesola AO, Tinckler LF, de Beaux J (1967) Incidence of diverticulitis. Scand J Gastroenterol 2:77–80

    Article  CAS  PubMed  Google Scholar 

  20. Janes S, Meagher A, Frizelle FA (2005) Elective surgery after acute diverticulitis. Br J Surg 92:133–142

    Article  CAS  PubMed  Google Scholar 

  21. Chapman JR, Dozois EJ, Wolff BG, Gullerud RE, Larson DR (2006) Diverticulitis: a progressive disease? Do multiple recurrences predict less favorable outcomes? Ann Surg 243:876–830

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ritz JP, Lehmann KS, Frericks B, Stroux A, Buhr HJ, Holmer C (2011) Outcome of patients with acute sigmoid diverticulitis: multivariate analysis of risk factors for free perforation. Surgery 149:606–613

    Article  PubMed  Google Scholar 

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Funding

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Authors and Affiliations

  1. Department of Surgery, Galliera Hospital, Genoa, Italy

    Gian Andrea Binda

  2. Italian Group of Diverticular Disease (GRIMAD), Rome, Italy

    Gian Andrea Binda, M. Carabotti, R. Cirocchi, R. Nascimbeni, A. Amato, N. Vettoretto, R. Cuomo & B. Annibale

  3. Department of Epidemiology, Lazio Regional Health Service, Rome, Italy

    F. Mataloni & L. Pinnarelli

  4. Clinical Epidemiology Unit, Ospedale Policlinico San Martino, Genoa, Italy

    M. Bruzzone

  5. Medical-Surgical Department of Clinical Sciences and Translational Medicine, Sapienza University, Rome, Italy

    M. Carabotti & B. Annibale

  6. Department of General Surgery and Surgical Oncology, Hospital of Terni, University of Perugia, Terni, Italy

    R. Cirocchi

  7. Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy

    R. Nascimbeni

  8. Department of Internal Medicine, Università Cattolica del Sacro Cuore, Rome, Italy

    G. Gambassi

  9. Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy

    G. Gambassi

  10. Department of Surgery, Borea Hospital, Sanremo, Imperia, Italy

    A. Amato

  11. Department of Surgery, Montichiari, Ospedali Civili Brescia, Brescia, Italy

    N. Vettoretto

  12. Department of Clinical Medicine and Surgery, Federico II University, Napoli, Italy

    R. Cuomo

Authors
  1. Gian Andrea Binda
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  2. F. Mataloni
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  3. M. Bruzzone
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  4. M. Carabotti
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  5. R. Cirocchi
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  6. R. Nascimbeni
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  7. G. Gambassi
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  8. A. Amato
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  9. N. Vettoretto
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  10. L. Pinnarelli
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  11. R. Cuomo
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  12. B. Annibale
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Corresponding author

Correspondence to Gian Andrea Binda.

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The authors declare that they have no conflict of interest.

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This article does not contain any studies with human partecipants performed by any authors.

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Binda, G.A., Mataloni, F., Bruzzone, M. et al. Trends in hospital admission for acute diverticulitis in Italy from 2008 to 2015. Tech Coloproctol 22, 597–604 (2018). https://doi.org/10.1007/s10151-018-1840-z

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  • DOI: https://doi.org/10.1007/s10151-018-1840-z

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