INTRODUCTION: Diverticular disease is a common medical problem, but it is unknown if lower socioeconomic status (SES) affects patient outcomes in diverticular disease. MATERIAL AND METHODS: The New York (NY) State Inpatient Database was used to query 8,117 cases of diverticular disease occurring in patients aged 65-85 in 2006. Race and SES were assessed by creating a composite score based on race, primary insurance payer, and median income bracket. RESULTS: Primary outcomes were differences in disease presentation, use of elective surgery, complication rates when surgery was performed, and overall mortality and length of stay. Patients of lower SES were younger, more likely to be female, to have multiple co-morbid conditions, to present as emergent/urgent admissions, and to present with diverticulitis complicated by hemorrhage (p < 0.0001). DISCUSSION: Overall, patients of low SES were less likely to receive surgical intervention, while rates of surgery were similar in elective cases. When surgery was performed, patients of lower SES had similar complication rates (25.4% vs. 20.2%, p = 0.06) and higher overall mortality (9.0% vs. 4.4%, p = 0.003). CONCLUSION: Patients of low SES who are admitted with diverticular disease have an increased likelihood to present emergently, have worse disease on admission, and are less likely to receive surgery.
INTRODUCTION:Diverticular disease is a common medical problem, but it is unknown if lower socioeconomic status (SES) affects patient outcomes in diverticular disease. MATERIAL AND METHODS: The New York (NY) State Inpatient Database was used to query 8,117 cases of diverticular disease occurring in patients aged 65-85 in 2006. Race and SES were assessed by creating a composite score based on race, primary insurance payer, and median income bracket. RESULTS: Primary outcomes were differences in disease presentation, use of elective surgery, complication rates when surgery was performed, and overall mortality and length of stay. Patients of lower SES were younger, more likely to be female, to have multiple co-morbid conditions, to present as emergent/urgent admissions, and to present with diverticulitis complicated by hemorrhage (p < 0.0001). DISCUSSION: Overall, patients of low SES were less likely to receive surgical intervention, while rates of surgery were similar in elective cases. When surgery was performed, patients of lower SES had similar complication rates (25.4% vs. 20.2%, p = 0.06) and higher overall mortality (9.0% vs. 4.4%, p = 0.003). CONCLUSION:Patients of low SES who are admitted with diverticular disease have an increased likelihood to present emergently, have worse disease on admission, and are less likely to receive surgery.
Authors: John D Birkmeyer; Andrea E Siewers; Emily V A Finlayson; Therese A Stukel; F Lee Lucas; Ida Batista; H Gilbert Welch; David E Wennberg Journal: N Engl J Med Date: 2002-04-11 Impact factor: 91.245
Authors: Robert W Eppsteiner; Nicholas G Csikesz; Jessica P Simons; Jennifer F Tseng; Shimul A Shah Journal: J Gastrointest Surg Date: 2008-08-13 Impact factor: 3.452
Authors: Ethan A Halm; Stanley Tuhrim; Jason J Wang; Mary Rojas; Caron Rockman; Thomas S Riles; Mark R Chassin Journal: Stroke Date: 2009-05-21 Impact factor: 7.914
Authors: Robert W Eppsteiner; Nicholas G Csikesz; James T McPhee; Jennifer F Tseng; Shimul A Shah Journal: Ann Surg Date: 2009-04 Impact factor: 12.969
Authors: Rajiv P Lahiri; Aliza Abeles; Katherine M Burnand; William Alazawi; Satyajit Bhattacharya; Graham R Foster; Charles H Knowles Journal: United European Gastroenterol J Date: 2013-06 Impact factor: 4.623
Authors: Andrew S Miller; Kathryn Boyce; Benjamin Box; Matthew D Clarke; Sarah E Duff; Niamh M Foley; Richard J Guy; Lisa H Massey; George Ramsay; Dominic A J Slade; James A Stephenson; Phil J Tozer; Danette Wright Journal: Colorectal Dis Date: 2021-02 Impact factor: 3.917
Authors: Saif Hamdan; Sunil Kripalani; Timothy M Geiger; Bradley M Dennis; Molly M Ford; Zhiguo Zhao; Fei Ye; Alexander T Hawkins Journal: Surgery Date: 2021-06-26 Impact factor: 3.982