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Temporal changes in the management of diverticulitis.
J Surg Res 2005; 124(2):318-23JS

Abstract

PURPOSE

This study was designed to evaluate temporal trends in the use and type of operative and non-operative interventions in the management of diverticulitis.

METHODS

A retrospective cohort using a statewide administrative database was used to identify all patients hospitalized for diverticulitis in the state of Washington (1987-2001). Poisson and logistic regression were used to calculate changes in the frequency of hospitalization, operative and percutaneous interventions, and colostomy over time.

RESULTS

Of the 25,058 patients hospitalized non-electively with diverticulitis (mean age 69 +/- 16, 60% female) there were only minimal changes in the frequency of admissions over time (0.006% increase per year-IRR 1.00006 95% CI 1.00004, 1.00008). The odds of an emergency colectomy at initial hospitalization decreased by 2% each year (OR 0.98 95% CI 0.98, 0.99) whereas the odds of percutaneous abscess drainage increased 7% per year (OR 1.07 95% CI 1.05, 1.1). Among patients undergoing percutaneous drainage, the odds of operative interventions decreased by 9% compared to patients who did not have a percutaneous intervention (OR 0.91 95% CI 0.87, 0.94). The proportion of patients undergoing colostomy during emergency operations remained essentially stable over time (range 49-61%), as did the proportion of patients undergoing prophylactic colectomy after initial non-surgical management (approximately 10%).

CONCLUSIONS

There was a minimal increase in the frequency of diverticulitis admissions over time. A rise in percutaneous drainage procedures was associated with a decrease in emergency operative interventions. The proportion of patients undergoing colostomy remained stable, and there does not seem to be a significant increase in the use of one-stage procedures for diverticulitis.

Authors+Show Affiliations

Department of Surgery, University of Washington, Seattle, WA 98195-6410, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

15820264

Citation

Salem, Leon, et al. "Temporal Changes in the Management of Diverticulitis." The Journal of Surgical Research, vol. 124, no. 2, 2005, pp. 318-23.
Salem L, Anaya DA, Flum DR. Temporal changes in the management of diverticulitis. J Surg Res. 2005;124(2):318-23.
Salem, L., Anaya, D. A., & Flum, D. R. (2005). Temporal changes in the management of diverticulitis. The Journal of Surgical Research, 124(2), pp. 318-23.
Salem L, Anaya DA, Flum DR. Temporal Changes in the Management of Diverticulitis. J Surg Res. 2005;124(2):318-23. PubMed PMID: 15820264.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Temporal changes in the management of diverticulitis. AU - Salem,Leon, AU - Anaya,Daniel A, AU - Flum,David R, PY - 2004/10/05/received PY - 2005/4/12/pubmed PY - 2005/5/25/medline PY - 2005/4/12/entrez SP - 318 EP - 23 JF - The Journal of surgical research JO - J. Surg. Res. VL - 124 IS - 2 N2 - PURPOSE: This study was designed to evaluate temporal trends in the use and type of operative and non-operative interventions in the management of diverticulitis. METHODS: A retrospective cohort using a statewide administrative database was used to identify all patients hospitalized for diverticulitis in the state of Washington (1987-2001). Poisson and logistic regression were used to calculate changes in the frequency of hospitalization, operative and percutaneous interventions, and colostomy over time. RESULTS: Of the 25,058 patients hospitalized non-electively with diverticulitis (mean age 69 +/- 16, 60% female) there were only minimal changes in the frequency of admissions over time (0.006% increase per year-IRR 1.00006 95% CI 1.00004, 1.00008). The odds of an emergency colectomy at initial hospitalization decreased by 2% each year (OR 0.98 95% CI 0.98, 0.99) whereas the odds of percutaneous abscess drainage increased 7% per year (OR 1.07 95% CI 1.05, 1.1). Among patients undergoing percutaneous drainage, the odds of operative interventions decreased by 9% compared to patients who did not have a percutaneous intervention (OR 0.91 95% CI 0.87, 0.94). The proportion of patients undergoing colostomy during emergency operations remained essentially stable over time (range 49-61%), as did the proportion of patients undergoing prophylactic colectomy after initial non-surgical management (approximately 10%). CONCLUSIONS: There was a minimal increase in the frequency of diverticulitis admissions over time. A rise in percutaneous drainage procedures was associated with a decrease in emergency operative interventions. The proportion of patients undergoing colostomy remained stable, and there does not seem to be a significant increase in the use of one-stage procedures for diverticulitis. SN - 0022-4804 UR - https://www.unboundmedicine.com/medline/citation/15820264/Temporal_changes_in_the_management_of_diverticulitis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-4804(04)00674-2 DB - PRIME DP - Unbound Medicine ER -