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CMAJ : Canadian Medical Association... Sep 2022
Topics: Humans; Diverticulitis; Acute Disease
PubMed: 36265064
DOI: 10.1503/cmaj.220139 -
Cellular and Molecular Gastroenterology... 2020This article reviews epidemiological evidence of heritability and putative mechanisms in diverticular disease, with greatest attention to 3 recent studies of genetic... (Review)
Review
This article reviews epidemiological evidence of heritability and putative mechanisms in diverticular disease, with greatest attention to 3 recent studies of genetic associations with diverticular disease based on genome-wide or whole-genome sequencing studies in large patient cohorts. We provide an analysis of the biological plausibility of the significant associations with gene variants reported and highlight the relevance of ANO1, CPI-17 (aka PPP1R14A), COLQ6, COL6A1, CALCB or CALCA, COL6A1, ARHGAP15, and S100A10 to colonic neuromuscular function and tissue properties that may result in altered compliance and predispose to the development of diverticular disease. Such studies also identify candidate genes for future studies.
Topics: Colon; Diverticulitis, Colonic; Genetic Predisposition to Disease; Genome-Wide Association Study; Humans; Molecular Epidemiology; Polymorphism, Single Nucleotide
PubMed: 31351939
DOI: 10.1016/j.jcmgh.2019.07.007 -
International Journal of Infectious... Nov 2022Despite the availability of international guidelines advocating shorter treatment durations, nonadherence to them is common. We assessed duration of antibiotic treatment...
OBJECTIVES
Despite the availability of international guidelines advocating shorter treatment durations, nonadherence to them is common. We assessed duration of antibiotic treatment for diverticulitis, complicated urinary tract infection (UTI), and endocarditis.
METHODS
Medical records of patients hospitalized with the previously stated diseases in 2017 and 2018 were randomly selected at a Swiss tertiary care hospital. The appropriateness of antibiotic treatment duration was assessed according to international and local guidelines.
RESULTS
A total of 243 patients were included in the study: 100 with diverticulitis, 200 with complicated UTI, and 43 with endocarditis. The dherence to local and international guidelines was 11% and 18% in diverticulitis, 39% and 40% in complicated UTI, and 84% and 86% in endocarditis, respectively. Nonadherence was primarily due to the prolonged treatment in diverticulitis and complicated UTI with a median duration of antibiotic treatment of 11 days (interquartile range 10-13) and 14 days (interquartile range 10-15), respectively. When pooling diverticulitis and complicated UTI cases, the identification of a pathogen in any microbiological sample was associated with an improved adherence to local guidelines in addition to hospitalization in a medical ward and infectious diseases consultation.
CONCLUSION
Prolonged courses of antibiotic treatment were common and the treatment adherence to guidelines were poor in diverticulitis, moderate in complicated UTI, and excellent in endocarditis.
Topics: Humans; Anti-Bacterial Agents; Retrospective Studies; Urinary Tract Infections; Endocarditis; Diverticulitis
PubMed: 36150662
DOI: 10.1016/j.ijid.2022.09.025 -
Digestive Diseases and Sciences Oct 2017The aim of this study was to analyze recent trends in emergency department (ED) visits for diverticulitis between 2006 and 2013.
GOALS
The aim of this study was to analyze recent trends in emergency department (ED) visits for diverticulitis between 2006 and 2013.
BACKGROUND
Acute diverticulitis is a serious medical condition that frequently leads to ED visits, hospitalizations, and surgeries resulting in a significant health care burden.
METHODS
Data were obtained from the National Emergency Department Sample (NEDS) records in which diverticulitis (ICD-9-CM codes 562.11 and 562.13) was the primary diagnosis in the ED between 2006 and 2013. The NEDS collects data from more than 25 million visits in over 950 hospital emergency departments and is weighted to provide national estimates. Our findings reflected patient and hospital characteristics such as demographics, geographical region, and total charges for ED and inpatient stays.
RESULTS
Between 2006 and 2013, the rate of diverticulitis-related ED visits increased by 26.8% from 89.8 to 113.9 visits per 100,000 population. The aggregate national cost of diverticulitis-related ED visits increased by 105%, from approximately $822 million in 2006 to over $1.6 billion in 2013. Cost data were adjusted for inflation and reported in 2015 dollars. The percentage of individuals admitted to the same hospital from the ED decreased from 58.0 to 47.1% from 2006 to 2013, respectively, while the rate of bowel surgeries per 100,000 ED visits for diverticulitis decreased by 33.7% from 2006 to 2013.
CONCLUSIONS
The number of ED visits due to diverticulitis and associated costs continued to rise between 2006 and 2013, while the rate of bowel surgeries and inpatient admissions through the ED for diverticulitis decreased.
Topics: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Databases, Factual; Digestive System Surgical Procedures; Diverticulitis; Emergency Service, Hospital; Female; Healthcare Disparities; Hospital Costs; Hospital Mortality; Humans; Length of Stay; Male; Middle Aged; Patient Admission; Sex Distribution; Time Factors; United States; Young Adult
PubMed: 28332105
DOI: 10.1007/s10620-017-4525-y -
Surgery Dec 2021Racial discrepancies in treatment and outcomes of acute diverticulitis have been observed, yet underlying factors are poorly understood. We aimed to identify racial...
BACKGROUND
Racial discrepancies in treatment and outcomes of acute diverticulitis have been observed, yet underlying factors are poorly understood. We aimed to identify racial inequalities in health literacy among patients hospitalized with acute diverticulitis and characterize factors associated with more severe presentation.
METHODS
We performed a retrospective cohort analysis of 947 Black or White patients admitted with acute diverticulitis at a quaternary referral center from January 2009 through September 2019. Health literacy was determined by the validated Brief Health Literacy Screening, and socioeconomic status was defined by the area deprivation index, a composite of multiple neighborhood socioeconomic deprivation measures. The primary outcome was severity of disease presentation represented by systemic inflammatory response syndrome criteria; secondary outcomes included intensive care unit admission, length of stay, and invasive interventions.
RESULTS
Among all study participants, 121 (12.8%) self-identified as Black. Overall, 140 (14.8%) patients had inadequate health literacy, and 495 (52.3%) had area deprivation index greater than the national median. There was no association between race or area deprivation index and health literacy. A total of 340 (35.9%) patients met criteria for systemic inflammatory response syndrome, and 88 (9.3%) underwent an intervention; median length of stay was 3.5 days. Race, health literacy, and area deprivation index were not significantly associated with outcomes (P > .05).
CONCLUSION
Among patients with acute diverticulitis, no difference in severity of presentation by race, health literacy, or area deprivation index was observed. These findings suggest that differences in presentation of acute diverticulitis may not be driven by these social factors. Future studies should include considerations of clinical characteristics of acute diverticulitis, such as the role of access and underuse of healthcare resources.
Topics: Aged; Diverticulitis; Female; Health Literacy; Health Status Disparities; Hospitalization; Humans; Male; Middle Aged; Racial Groups; Retrospective Studies; Severity of Illness Index; Socioeconomic Factors
PubMed: 34183181
DOI: 10.1016/j.surg.2021.05.049 -
American Family Physician Aug 2021
Review
Topics: Acute Disease; Disease Management; Diverticulitis, Colonic; Humans; Tomography, X-Ray Computed
PubMed: 34383434
DOI: No ID Found -
World Journal of Gastroenterology Nov 2014Diverticulitis is one of the leading indications for elective colon resection. Surgeons are trained to offer elective operations after a few episodes of diverticulitis... (Review)
Review
Diverticulitis is one of the leading indications for elective colon resection. Surgeons are trained to offer elective operations after a few episodes of diverticulitis in order to prevent future recurrences and potential emergency. However, most emergency surgery happens during the initial presentation. After recovery from an episode, much of the subsequent management of diverticulitis occurs in the outpatient setting, rendering inpatient "episode counting" a poor measure of the severity or burden of disease. Evidence also suggests that the risk of recurrence of diverticulitis is small and similar with or without an operation. Accordingly, contemporary evaluations of the epidemiologic patterns of treatments for diverticulitis have failed to demonstrate that the substantial rise in elective surgery over the last few decades has been successful at preventing emergency surgery at a population level. Multiple professional societies are calling to "individualize" decisions for elective colectomy and there is an international focus on "appropriate" indications for surgery. The rethinking of elective colectomy should come from a patient-centered approach that considers the risks of recurrence, quality of life, patient wishes and experiences about surgical and medical treatment options as well as operative morbidity and risks.
Topics: Colectomy; Diverticulitis, Colonic; Elective Surgical Procedures; Humans; Patient Selection; Recurrence; Risk Assessment; Risk Factors; Severity of Illness Index; Time Factors; Treatment Outcome
PubMed: 25469029
DOI: 10.3748/wjg.v20.i44.16609 -
British Medical Journal Mar 1968
Topics: Black or African American; Black People; Diet; Diverticulitis; Diverticulum; Edible Grain; Ethiopia; Humans; Kuwait; United States
PubMed: 4966935
DOI: 10.1136/bmj.1.5591.579 -
Revista Espanola de Enfermedades... Mar 2015Colonic diverticular disease is a chronic disorder presenting with a variety of abdominal symptoms and recurrent episodes of acute diverticulitis. It is close linked to... (Meta-Analysis)
Meta-Analysis Review
Colonic diverticular disease is a chronic disorder presenting with a variety of abdominal symptoms and recurrent episodes of acute diverticulitis. It is close linked to age so its prevalence has risen notably during the last decades in western countries, increasing costs related to medical attention. Recently, several works have provided evidence to a series of measures that could improve the outcomes as well as reduce expenses associated to this process.The aim of the present review is to expose a view of the new trends in the management of diverticulitis and colonic diverticular disease, based on the highest clinical evidence available.
Topics: Anastomosis, Surgical; Colonic Diseases; Disease Management; Diverticulitis; Diverticulitis, Colonic; Diverticulosis, Colonic; Humans; Laparoscopy; Peritoneal Lavage
PubMed: 25733040
DOI: No ID Found -
International Journal of Surgery... Jan 2015Diverticulosis of the colon is a common disease with an increasing incidence in Western Countries. It represents a significant burden for National Health Systems in... (Review)
Review
Diverticulosis of the colon is a common disease with an increasing incidence in Western Countries. It represents a significant burden for National Health Systems in terms of costs. Most people with diverticulosis remain asymptomatic, about one quarter of them will develop an episode of symptomatic diverticular disease and up to 5% an episode of acute diverticulitis (AD). AD shows an increasing prevalence. Recently, progresses have been reached about the etiology, pathogenesis, natural course of diverticular disease and its complications; improvements about the diagnosis and treatment of AD have been achieved. However, the treatment options are not well defined because of a lack of solid evidence: there are few systematic reviews and well conducted trials to guide decision-making in the treatment of AD and in the prevention of its recurrences. This review describes the recent evidence about diagnosis, treatment and prevention of AD.
Topics: Diverticulitis, Colonic; Humans; Prevalence; Recurrence
PubMed: 25497007
DOI: 10.1016/j.ijsu.2014.12.012