S. Patil1, S. H. Fletcher1, F. C. Nance1, R. S. Chamberlain1,2,3 1Saint Barnabas Medical Center,General Surgery,Livingston, NJ, USA 2University Of Medicine And Dentistry Of New Jersey,Newark, NJ, USA 3Saint George’s University,Grenada, Grenada, Grenada
Introduction: Acute diverticulitis (AD) and relapse are common indications for colectomy. This study examines the impact of AD on the type of operation performed and the clinical outcome.
Methods: Data on 168,816 AD patients was abstracted from the State Inpatient Database (SID) database (2006-2011). Readmission rates (New York and California) for Young (Y; 20-40 years and Older (O; >41 years) patients were compared.
Results: 54,302 (32.2%) readmissions for AD were identified. Readmissions were higher in the young cohort (NY; 37.5%, CA; 38.6%. vs O NY; 32.9%, CA; 30.1%, p<0.001). Young males (NY; 40.3%, CA; 32.6%) and O females (NY; 34.1%, CA; 30.4%) had higher readmissions, p<0.001. NY caucasians ( Y 39.6% and O 33.4%) and CA African Americans (Y 42.6% and O32.3%) had higher readmission rates, p<0.001. Younger patients had at least one co-morbidity, with 51.5% having >3 co-morbidities, p< 0.001. Disease free interval decreased and LOS increased with each readmission, p<0.001. 7% had surgery during the initial admission, which increased to ≥40% by the 2nd or 3rd admission. Young patients underwent more primary resection and anastomosis (Y: NY; 57.9% and CA 45.8% vs. O: CA; 38.7% and NY us 38.7%, p <0.001). No differences were noted in regards to diverting ileostomy, diagnostic laparoscopy or percutaneous drainage.
Conclusion: Readmission for recurrent diverticulitis is common in all age groups. Disease-free interval decreases and LOS and surgical intervention increase with each readmission resulting in a higher % of patients undergoing surgery at each subsequent admission. One stage procedure is among the most common procedures performed for AD.
