Ryan Lamm1, Steven N Mathews2, Jie Yang3, Lijuan Kang3, Dana Telem4, Aurora D Pryor4, Mark Talamini5, Jill Genua6. 1. Stony Brook University School of Medicine, Stony Brook University Medical Center, 26 Barker Drive, Stony Brook, NY, 11790, USA. ryan.lamm@stonybrookmedicine.edu. 2. Stony Brook University School of Medicine, Stony Brook University Medical Center, 26 Barker Drive, Stony Brook, NY, 11790, USA. 3. Department of Family, Population and Preventative Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA. 4. Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA. 5. Chairman of Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA. 6. Division of Colon and Rectal Surgery, Stony Brook University Medical Center, Stony Brook, NY, USA.
Abstract
INTRODUCTION: Management of acute diverticulitis (AD) has considerably changed over time. This study evaluates practice patterns for diverticulitis across demographic populations in New York State. METHODS: Two hundred sixty-five thousand seven hundred twenty-four patients with acute diverticulitis were analyzed from 1995 to 2014 from the New York-Statewide Planning and Research Cooperative System database. The likelihood of having surgery over time was compared across patient demographic subgroups using logistic regression models to calculate estimated odds ratio with their 95 % confidence intervals. Using Chi-square test and Welch's t test, categorical and continuous variables were compared. RESULTS: From 1995 to 2014, there was an increase in newly diagnosed diverticulitis patients while the proportion of those patients undergoing operative management steadily decreased (31 to 10 %, p < 0.0001). Of those receiving surgery, emergent surgeries decreased (58 to 47 %, p < 0.0001) while elective surgeries increased (42 to 53 %, p < 0.0001) with the odds of having emergency surgery decreasing by 4 % annually (OR 0.96 (0.95-0.97), p < 0.0001). With the exception of patients greater than 80 years old, these linear trends were substantiated across patient subgroups. CONCLUSIONS: Over the past 20 years in New York State, there has been an increase in diverticulitis diagnoses and hospital admissions, with a decrease in surgeries performed reflecting a shift towards conservative management and more effective antibiotic treatment.
INTRODUCTION: Management of acute diverticulitis (AD) has considerably changed over time. This study evaluates practice patterns for diverticulitis across demographic populations in New York State. METHODS: Two hundred sixty-five thousand seven hundred twenty-four patients with acute diverticulitis were analyzed from 1995 to 2014 from the New York-Statewide Planning and Research Cooperative System database. The likelihood of having surgery over time was compared across patient demographic subgroups using logistic regression models to calculate estimated odds ratio with their 95 % confidence intervals. Using Chi-square test and Welch's t test, categorical and continuous variables were compared. RESULTS: From 1995 to 2014, there was an increase in newly diagnosed diverticulitispatients while the proportion of those patients undergoing operative management steadily decreased (31 to 10 %, p < 0.0001). Of those receiving surgery, emergent surgeries decreased (58 to 47 %, p < 0.0001) while elective surgeries increased (42 to 53 %, p < 0.0001) with the odds of having emergency surgery decreasing by 4 % annually (OR 0.96 (0.95-0.97), p < 0.0001). With the exception of patients greater than 80 years old, these linear trends were substantiated across patient subgroups. CONCLUSIONS: Over the past 20 years in New York State, there has been an increase in diverticulitis diagnoses and hospital admissions, with a decrease in surgeries performed reflecting a shift towards conservative management and more effective antibiotic treatment.
Authors: A Amato; F Mataloni; M Bruzzone; M Carabotti; R Cirocchi; R Nascimbeni; G Gambassi; N P Vettoretto; L Pinnarelli; R Cuomo; B Annibale; V Fontana; G A Binda Journal: Tech Coloproctol Date: 2020-02-04 Impact factor: 3.781
Authors: R Nascimbeni; A Amato; R Cirocchi; A Serventi; A Laghi; M Bellini; G Tellan; M Zago; C Scarpignato; G A Binda Journal: Tech Coloproctol Date: 2020-11-05 Impact factor: 3.781