Diverticular disease hospital admissions are increasing, with poor outcomes in the elderly and emergency admissions

Summary Background  Diverticular disease has a changing disease pattern with limited epidemiological data. Aim  To describe diverticular disease admission rates and associated outcomes through national population study. Methods  Data were obtained from the English ‘Hospital Episode Statistics’ datab...

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Bibliographic Details
Published in:Alimentary pharmacology & therapeutics 2009-12, Vol.30 (11‐12), p.1171-1182
Main Authors: JEYARAJAH, S., FAIZ, O., BOTTLE, A., AYLIN, P., BJARNASON, I., TEKKIS, P. P., PAPAGRIGORIADIS, S.
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Biological and medical sciences
Digestive system
Diverticulitis, Colonic - epidemiology
Diverticulitis, Colonic - mortality
Diverticulitis, Colonic - surgery
Emergency Medicine - statistics & numerical data
England - epidemiology
Female
Gastroenterology. Liver. Pancreas. Abdomen
Hospitalization - statistics & numerical data
Humans
Incidence
Medical sciences
Middle Aged
Patient Admission - statistics & numerical data
Patient Readmission
Pharmacology. Drug treatments
Treatment Outcome
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Summary:Summary Background  Diverticular disease has a changing disease pattern with limited epidemiological data. Aim  To describe diverticular disease admission rates and associated outcomes through national population study. Methods  Data were obtained from the English ‘Hospital Episode Statistics’ database between 1996 and 2006. Primary outcomes examined were 30‐day overall and 1‐year mortality, 28‐day readmission rates and extended length of stay (LOS) beyond the 75th percentile (median inpatient LOS = 6 days). Multiple logistic regression analysis was used to determine independent predictors of these outcomes. Results  Between the study dates 560 281 admissions with a primary diagnosis of diverticular disease were recorded in England. The national admission rate increased from 0.56 to 1.20 per 1000 population/year. 232 047 (41.4%) were inpatient admissions and, of these, 55 519 (23.9%) were elective and 176 528 (76.1%) emergency. Surgery was undertaken in 37 767 (16.3%). The 30‐day mortality was 5.1% (n = 6735) and 1‐year mortality was 14.5% (n = 11 567). The 28‐day readmission rate was 9.6% (n = 21 160). Increasing age, comorbidity and emergency admission were independent predictors of all primary outcomes. Conclusions  Diverticular disease admissions increased over the course of the study. Patients of increasing age, admitted as emergency and significant comorbidity should be identified, allowing management modification to optimize outcomes.
ISSN:0269-2813
1365-2036
DOI:10.1111/j.1365-2036.2009.04098.x