Diverticulitis: does age matter?

Horesh, Nir; Shwaartz, Chaya; Amiel, Imri; Shabtai, Esther; Lebedeyev, Alexander; Nadler, R; Rosin, Danny; Gutman, Mordechai; Zmora, Oded

doi:10.1111/1751-2980.12350

Cited by 11 publications

(19 citation statements)

References 24 publications

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“…This is in contrast to other studies which show the rate per 100,000 ED visits did not increase significantly among the younger population [8,13,22]. Our study also found that the younger age group had the lowest rate of bowel surgeries of all age groups, which contrasts other studies suggesting that the younger age group may have more severe disease and more likely to require immediate surgical intervention due to complications [10,21,23]. …”

Section: Discussioncontrasting

confidence: 99%

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Emergency Department Burden of Diverticulitis in the USA, 2006–2013

et al. 2017

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Goals The aim of this study was to analyze recent trends in ED visits for diverticulitis between 2006 and 2013. Background Acute diverticulitis is a serious medical condition that frequently leads to emergency department (ED) visits, hospitalizations, and surgeries resulting in a significant health care burden. Methods Data were obtained from the National Emergency Department Sample (NEDS) records in which diverticulitis (ICD-9-CM codes 562.11 and 562.13) was the primary diagnosis in the ED between 2006 and 2013. The NEDS collects data from more than 25 million visits in over 950 hospital emergency departments and is weighted to provide national estimates. Our findings reflected patient and hospital characteristics such as demographics, geographical region, and total charges for ED and inpatient stays. Results Between 2006 and 2013, the rate of diverticulitis-related ED visits increased by 26.8% from 89.8 to 113.9 visits per 100,000 population. The aggregate national cost of diverticulitis-related ED visits increased by 105%, from approximately $822 million in 2006 to over $1.6 billion in 2013. Cost data were adjusted for inflation and reported in 2015 dollars. The percentage of individuals admitted to the same hospital from the ED decreased from 58.0% to 47.1% from 2006 to 2013 respectively while the rate of bowel surgeries per 100,000 ED visits for diverticulitis decreased 33.7% from 2006 to 2013. Conclusions The number of ED visits due to diverticulitis and associated costs continued to rise between 2006 and 2013, while the rate of bowel surgeries and inpatient admissions through the ED for diverticulitis decreased.

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Section: Discussioncontrasting

confidence: 99%

“…The development of acute diverticulitis is associated with obesity, smoking, diet, lack of physical activity, and the use of nonsteroidal anti-inflammatory drugs [9]. Younger individuals with diverticulitis tend to have similar or less severe disease, though they tend to be re-admitted more frequently [8,10,11]. …”

Section: Introductionmentioning

confidence: 99%

Emergency Department Burden of Diverticulitis in the USA, 2006–2013

et al. 2017

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“…15 Similar findings were observed in an Israeli cohort; although younger patients were more likely to have extraluminal air on CT, the intraoperative Hinchey score and the need for emergency or multiple surgeries did not differ between the older and younger groups. 16 There were no differences in disease complexity, peritonitis, laboratory findings, and presence of fistula or abscess among older (> 50 years) and younger patients. Younger patients were more likely to have readmissions or diverticular complications, possibly due to their earlier discharge compared with those > 50 years of age.…”

Section: Risk Factors Agementioning

confidence: 81%

“…13,14 Historically, elective resection was recommended after the first attack of complicated diverticulitis in those under the age of 40 due to the belief that young patients with diverticulitis have more aggressive pathology. 15,16 Recent work has challenged this view, however. 14,15,17,18 In a retrospective review of all abdominopelvic computed tomography (CT) scans in those with diverticulitis over a 5-year period in a single institution, young patients (age 50 years) were more likely to be male, have extraluminal air, and have greater colonic wall thickness.…”

Section: Risk Factors Agementioning

confidence: 99%

Pathophysiology and Epidemiology of Diverticular Disease

Talutis

Kuhnen

2020

Clin Colon Rectal Surg

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Diverticular disease exists on a spectrum, ranging from asymptomatic diverticulosis to complicated diverticulitis. Incidence of diverticulitis in western nations has increased in recent years, although the factors that influence the progression from diverticulosis to diverticulitis are unknown. Geographic/environmental influences, lifestyle variables, and microbiota of the gastrointestinal tract are some of the factors implicated in diverticular disease.

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“…Studies that included more than 20% right-sided diverticulitis were excluded. Studies that did not quantify the number of right-sided diverticulitis patients but were from Western origin were not excluded under the assumption that in the Western world the vast majority of cases (usually above 90% [ 12 – 14 ]) concern left-sided diverticulitis. Reviews, letters, and case reports were excluded.…”

Section: Methodsmentioning

confidence: 99%

A systematic review and meta-analysis of outpatient treatment for acute diverticulitis

Dijk

Bos

Boer

et al. 2018

Int J Colorectal Dis

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BackgroundThe shift from routine antibiotics towards omitting antibiotics for uncomplicated acute diverticulitis opens up the possibility for outpatient instead of inpatient treatment, potentially reducing the burden of one of the most common gastrointestinal diseases in the Western world.PurposeAssessing the safety and cost savings of outpatient treatment in acute colonic diverticulitis.MethodsPubMed and EMBASE were searched for studies on outpatient treatment of colonic diverticulitis, confirmed with computed tomography or ultrasound. Outcomes were readmission rate, need for emergency surgery or percutaneous abscess drainage, and healthcare costs.ResultsA total of 19 studies with 2303 outpatient treated patients were included. These studies predominantly excluded patients with comorbidity or immunosuppression, inability to tolerate oral intake, or lack of an adequate social network. The pooled incidence rate of readmission for outpatient treatment was 7% (95%CI 6–9%, I2 48%). Only 0.2% (2/1288) of patients underwent emergency surgery, and 0.2% (2/1082) of patients underwent percutaneous abscess drainage. Only two studies compared readmission rates outpatients that had similar characteristics as a control group of inpatients; 4.5% (3/66) and 6.3% (2/32) readmissions in outpatient groups versus 6.1% (4/66) and 0.0% (0/44) readmissions in inpatient groups (p = 0.619 and p = 0.174, respectively). Average healthcare cost savings for outpatient compared with inpatient treatment ranged between 42 and 82%.ConclusionOutpatient treatment of uncomplicated diverticulitis resulted in low readmission rates and very low rates of complications. Furthermore, healthcare cost savings were substantial. Therefore, outpatient treatment of uncomplicated diverticulitis seems to be a safe option for most patients.Electronic supplementary materialThe online version of this article (10.1007/s00384-018-3015-9) contains supplementary material, which is available to authorized users.

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Diverticulitis: does age matter?

Abstract: The clinical presentation of acute diverticulitis does not seem to be worse in the young population. Younger patients tend to have a more severe presentation on CT scan and more readmissions, but this did not translate to a more severe disease course.

Cited by 11 publications

References 24 publications

Emergency Department Burden of Diverticulitis in the USA, 2006–2013

Emergency Department Burden of Diverticulitis in the USA, 2006–2013

Pathophysiology and Epidemiology of Diverticular Disease

A systematic review and meta-analysis of outpatient treatment for acute diverticulitis

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