Incidence and lifetime risk of hospitalization and surgery for diverticular disease

Abstract

Background: Studies on incidence rates of first-time colonic diverticular disease are few, and population-based estimates of lifetime risk are lacking. In this observational study, the incidence, admission rates and lifetime risks of hospitalization and surgery for diverticular disease were investigated. Methods: Considering the entire Swedish population as an open cohort, incidence and admission rates, and lifetime risk estimates (considering death as a competing risk) of hospitalization and surgery for diverticular disease were calculated using data from cross-linked national registers and population statistics from 1987 to 2010.Results: In total, there were 144 107 hospital admissions for diverticular disease in 95 049 individual patients. Of these, 17 599 were admissions with bowel resection or stoma formation in 16 824 patients. The total number of person-years in the population during the study period was 213 949 897. Age-standardized incidence rates were 47⋅4 (95 per cent c.i. 47⋅1 to 47⋅7) for first-time hospitalization with diverticular disease and 8⋅4 (8⋅2 to 8⋅5) per 100 000 person-years for diverticular disease surgery. The corresponding admission rates (including readmissions) were 70⋅8 (70⋅4 to 71⋅2) and 8⋅7 (8⋅6 to 8⋅9) per 100 000 person-years. Following an increase in 1990-1994, rates stabilized. Based on incidence and mortality rates from 2000 to 2010, the estimated remaining lifetime risk of hospitalization from 30 years of age was 3⋅1 per cent in men and 5⋅0 per cent in women. The corresponding risk of surgery was 0⋅5 per cent in men and 0⋅8 per cent in women.Conclusion: Diverticular disease is a common reason for hospital admission, particularly in women, but rates are stable and the lifetime risk of surgery is low.

Cost-effectiveness of sigmoid resection with primary anastomosis or end colostomy for perforated diverticulitis: an analysis of the randomized Ladies trial

“…Acute diverticulitis is a common diagnosis in developed countries that is associated with considerable healthcare costs [1][2][3][4][5] . The incidence of perforated diverticulitis with purulent or faecal peritonitis (Hinchey grade III or IV) is increasing, emphasizing the need for cost-effective emergency surgical management 6,7 .…”

Self-Expandable Metal Stents for Left Sided Colon Obstruction from Diverticulitis. A Single Center Retrospective Series

“…Bowel sounds are usually hypoactive but can be normoactive. Patients can present with peritoneal signs (rigidity, guarding, rebound tenderness) with bowel wall perforation [5][6][7].…”

“…The incidence of diverticulitis is increasing in Western countries. Besides increasing age, other risk factors for diverticular disease include the use of NSAIDS, aspirin, steroids, opioids, smoking and sedentary lifestyle [6][7][8]. Diverticulitis can be further sub-classified into complicated and uncomplicated presentations.…”

Incidence and recurrence rate of sigmoid diverticulitis in patients requiring admission to hospital in Iceland from 1985 to 2014: nationwide population-based register study

“…An increased incidence of diverticular disease has also been reported in the USA (2000-2007 versus 1980-1989) 6 , England (1999-2000 versus 1989-1990) 12 and Scotland (2000-2010) 13 . However, a recent study 14 on diverticular disease in Sweden documented that between 1997 and 2010 the incidence did not increase, and in the population aged over 70 years there was a small but significant decrease in the incidence In 1995-2014 there was a linear trend for the decrease in the incidence; P for trend for all ages was 0⋅009 and for the age group 40-89 years it was less than 0⋅001. *Number of patients with sigmoid diverticulitis at discharge according to information read in the patient files in 50 records chosen randomly from all admissions for diverticular disease in the three periods.…”

“…An increased incidence of diverticular disease has also been reported in the USA (2000–2007 versus 1980–1989) 6 , England (1999–2000 versus 1989–1990) 12 and Scotland (2000–2010) 13 . However, a recent study 14 on diverticular disease in Sweden documented that between 1997 and 2010 the incidence did not increase, and in the population aged over 70 years there was a small but significant decrease in the incidence of diverticular disease. On this basis, the aim of this study was to analyse the incidence and recurrence of sigmoid diverticulitis requiring admission to hospital in Iceland from 1985 to 2014.…”