Incidence of acute diverticulitis compared to appendicitis in emergency wards: a 10-year nationwide register and cohort study from Finland

Saren, Roni; Aspegren, Sami; Paajanen, Hannu; Ukkonen, Mika; Käkelä, Pirjo

doi:10.1080/00365521.2022.2111225

Cited by 5 publications

(4 citation statements)

References 20 publications

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“…Our data showed an increasing number of hospitalizations for acute diverticulitis from 2010 to 2019, with a relative increase of 52.4% for this time period. These findings are consistent with previous studies reporting an increasing incidence of acute diverticulitis [1, 28–31]. While the rate of complicated diverticulitis increased over time, the rate of uncomplicated diverticulitis decreased between 2010 and 2019.…”

Section: Discussionsupporting

confidence: 92%

“…In‐hospital mortality was 1.8% in 2010 and 1.2% in 2019. These data are consistent with previously reported rates of in‐hospital mortality [30, 33]. The rates reported of in‐hospital mortality differed between patients who received surgery and patients who received conservative treatment and depended on several other factors (including age, comorbidities, stage of disease); therefore, comparisons with groups of patients in other studies are challenging.…”

Section: Discussionsupporting

confidence: 90%

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Inpatient treatment of acute diverticulitis between 2010 and 2021 – A German nationwide study about long‐term trends and effects of the SARS‐CoV‐2 pandemic

Decker,

Scheurig‐Münkler,

Luitjens

et al. 2023

Colorectal Disease

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AimThe aims of this study were to analyse all hospitalizations for acute diverticulitis in Germany from 2010 to 2021 and to assess the effects of the first 2 years of the SARS‐CoV‐2 pandemic on hospitalizations for acute diverticulitis.MethodUsing data from the German Federal Statistical Office, we analysed fully anonymized healthcare data of hospitalizations and treatment regimens with acute diverticulitis as the main diagnosis between 2010 and 2021. Logistic regression analyses for in‐hospital mortality were performed.ResultsA total of 608,162 hospitalizations were included. While the number of hospitalizations constantly increased until 2019 (+52.4%), a relative decrease of 10.1% was observed between 2019 and 2020, followed by stable numbers of hospitalizations in 2021 (+1.1% compared with 2020). In‐hospital mortality showed a relative decrease of 33.2% until 2019 and thereafter a relative increase of 26.9% in 2020 and of 7.5% in 2021. A 21.6% and a 19.3% drop in hospitalizations was observed during the first and second waves of the SARS‐CoV‐2 pandemic, mostly affecting hospitalizations for uncomplicated diverticulitis, with a corresponding 11.6% and 16.8% increase in admissions for complicated diverticulitis. Multivariable logistic regression analyses showed significantly higher in‐hospital mortality for hospitalizations in which surgery (OR = 2.76) and CT (OR = 1.32) were given, as well as lower mortality for women (OR = 0.88), whereas percutaneous drainage was not associated with higher in‐hospital mortality compared with conservative treatment (OR = 0.71).ConclusionThis study points out the long‐term trends in inpatient treatment for acute diverticulitis and the in‐hospital mortality risk factors of patients hospitalized for acute diverticulitis in a large nationwide cohort, as well as changes in these trends and factors resulting from the SARS‐CoV‐2 pandemic. These changes might be attributable to delayed diagnosis and thus more severe stages of disease as a result of containment measures.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionsupporting

confidence: 90%

Inpatient treatment of acute diverticulitis between 2010 and 2021 – A German nationwide study about long‐term trends and effects of the SARS‐CoV‐2 pandemic

Decker,

Scheurig‐Münkler,

Luitjens

et al. 2023

Colorectal Disease

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“…Of all patients, 438 (78%) had UAD and 124 (22%) CAD. Fifty-six patients (10%) had abscess (median size 4 [2‒12] cm) and six patients (1.1%) had peritonitis and only 1 patient (0.2%) had stricture. Of all patients 546 patients (97%) underwent nonoperative care and 16 patients (2.8%) operative care.…”

Section: Resultsmentioning

confidence: 99%

“…Acute diverticulitis (AD), which is the most common complication of diverticular disease, affects 4-7% of the patients [1,2]. The incidence of AD has been rising during the past decades [3]. Because the accuracy of clinical diagnosis of AD is low [4], the diagnosis of AD is commonly based on radiological assessment in many institutions.…”

Section: Introductionmentioning

confidence: 99%

Is reassessment of Computed Tomography Reports Worthwhile in Acute Diverticulitis?

Mäntymäki,

Grönroos,

Aronen

et al. 2024

Dig Surg

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Introduction Since the assessment of the disease severity in acute diverticulitis (AD) is of utmost importance to determine the optimal treatment and the need for follow-up investigations, we wanted to investigate whether the first CT report is compatible with daytime reassessment report and whether the value of initial report changes according to the experience of the radiologist. Methods Consecutive patients from tertiary referral center with AD were included. CT images done in the emergency department were initially analysed by either resident radiologists or consultant radiologists and then later reanalysed by consultant abdominal radiologists. Discrepancies between reports were noted. Results Of total of 562 patients with AD, CT images were reanalysed in 439 cases. In 22 reports (5.0%) the final report was significantly different from the initial report and management changed in 20 cases. In reports of uncomplicated acute diverticulitis (UAD) reanalysis changed initial assessment in 4.0% of the cases and in complicated acute diverticulitis (CAD) in 9.1%. When consultant and resident radiologists were compared, there was no significant difference. Conclusion Although no statistical difference could be noted between residents and consultants, the final report was significantly different in overall 5% of the cases when reanalysed at normal working hours by an experienced consultant abdominal radiologist. Therefore, we conclude that reassessment of CT reports is worthwhile in AD.

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A novel scoring system for predicting disease severity without CT imaging in acute diverticulitis

Mäntymäki,

Grönroos,

Karvonen

et al. 2024

Int J Colorectal Dis

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Purpose Clinical scoring could help physicians identify patients with suspected acute diverticulitis who would benefit from further evaluation using computed tomography imaging. The aim of the study was to identify risk factors for complicated acute diverticulitis and create a risk score to predict disease severity in acute diverticulitis. Methods Patients diagnosed with CT-verified acute diverticulitis between 2015 and 2017 were included. Data on patients’ clinical and laboratory findings and medical histories were collected retrospectively. Risk factors for complicated acute diverticulitis were identified using univariate and multivariate analyses. Continuous laboratory values were categorised by cut-off points determined using receiver operating characteristic (ROC) analysis. The Acute Diverticulitis Severity Score was formulated using logistic regression analysis. Results Of the total 513 patients included in the study, 449 (88%) had UAD, and 64 (12%) had CAD. Older age, significant comorbidities, C-reactive protein level, leucocyte count, vomiting, and body temperature were found to be independently associated with a higher risk for CAD. The novel Acute Diverticulitis Severity Score could reliably detect patients with CAD. The area under the ROC curve was 0.856 (p < 0.001) in discriminating disease severity. While higher scores indicate radiological studies, patients with low scores face an almost non-existent risk for complicated disease, making such studies possibly redundant. Conclusions The Acute Diverticulitis Severity Score accurately separated patients with uncomplicated disease from those at risk for complicated disease. This score can be applied in daily clinical practice to select patients requiring further investigation, consequently reducing healthcare costs and burdens.

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Incidence of acute diverticulitis compared to appendicitis in emergency wards: a 10-year nationwide register and cohort study from Finland

Cited by 5 publications

References 20 publications

Inpatient treatment of acute diverticulitis between 2010 and 2021 – A German nationwide study about long‐term trends and effects of the SARS‐CoV‐2 pandemic

Inpatient treatment of acute diverticulitis between 2010 and 2021 – A German nationwide study about long‐term trends and effects of the SARS‐CoV‐2 pandemic

Is reassessment of Computed Tomography Reports Worthwhile in Acute Diverticulitis?

A novel scoring system for predicting disease severity without CT imaging in acute diverticulitis

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