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Short-term mortality, readmission, and recurrence in treatment of acute diverticulitis with abscess formation: a nationwide register-based cohort study

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

The aim of the study was to investigate short-term mortality, readmission, and recurrence in a national cohort of patients with Hinchey Ib-II diverticulitis.

Methods

The retrospective cohort-investigation was conducted using a database consisting of the entire Danish population (n = 6,641,672) in year 2000–2012, formed by linking the Danish Registers. Patients admitted with acute Hinchey Ib-II diverticulitis were identified from ICD-10 discharge codes and stratified according to treatment into an operative, drainage, and antibiotics group. The primary outcome was 30-day mortality from admission, secondary outcomes were mortality, readmission, and recurrence within 30 days post-discharge. The study was reported using RECORD guidelines.

Results

A total of 3148 eligible patients were identified. The cohort had a mean age of 65.1 year, 25.6 % had previously been admitted with diverticulitis, and 48.1 % had registered comorbidities. Within 30 days from admission, 8.7 % of the patients died. Of patients discharged, 2.5 % died, 23.8 % was readmitted, and 5.9 % was readmitted due to diverticulitis within 30 days from discharge. In multivariate analyses, increasing age was associated with mortality at odds-ratio (95 % CI) 1.10 (1.09–1.12). Previous complicated and uncomplicated diverticulitis reduced mortality with odds-ratio 0.50 (0.33–0.76) and 0.73 (0.58–0.92), while uncomplicated diverticulitis also increased risk of recurrence with odds-ratio 1.51 (1.24–1.84). Glucocorticoid usage was associated with mortality with odds-ratio 1.49 (1.23–1.81) and readmission with odds-ratio 2.91 (1.24–6.80).

Conclusion

Acute diverticulitis with abscess formation is a severe and life-threatening condition. Direct comparisons of treatment groups were not possible due to possible confounding by indication.

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Authors and Affiliations

  1. Centre for Perioperative Optimization, Department of Surgery, Herlev Hospital, Herlev Ringvej 75, DK-2730, Herlev, Denmark

    Rasmus Gregersen, Kristoffer Andresen, Jakob Burcharth & Jacob Rosenberg

  2. Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark

    Rasmus Gregersen, Kristoffer Andresen & Jacob Rosenberg

  3. Department of Surgery, Hvidovre Hospital, Hvidovre, Denmark

    Hans-Christian Pommergaard

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  1. Rasmus Gregersen
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Correspondence to Rasmus Gregersen.

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Gregersen, R., Andresen, K., Burcharth, J. et al. Short-term mortality, readmission, and recurrence in treatment of acute diverticulitis with abscess formation: a nationwide register-based cohort study. Int J Colorectal Dis 31, 983–990 (2016). https://doi.org/10.1007/s00384-016-2568-8

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