Andrew J Kruger1, Khalid Mumtaz2, Ahmad Anaizi2, Rohan M Modi1, Hisham Hussan2, Cheng Zhang2, Alice Hinton2,3, Darwin L Conwell2, Somashekar G Krishna2, Peter P Stanich4. 1. Department of Internal Medicine, The Ohio State University Wexner Medical Center, Columbus, OH, USA. 2. Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W 12th Ave, Suite 200, Columbus, OH, 43210, USA. 3. Division of Biostatistics, College of Public Health, The Ohio State University, Columbus, OH, USA. 4. Division of Gastroenterology, Hepatology and Nutrition, The Ohio State University Wexner Medical Center, 395 W 12th Ave, Suite 200, Columbus, OH, 43210, USA. Peter.Stanich@osumc.edu.
Abstract
BACKGROUND: Diverticulitis in patients with cirrhosis has been associated with higher surgical mortality, but no prior studies evaluate non-surgical treatment results. AIMS: Our aim was to compare the outcomes of hospitalization for diverticulitis in patients with and without cirrhosis. METHODS: We utilized the Nationwide Inpatient Sample (2007-2013) for patients with and without cirrhosis hospitalized for diverticulitis. Patients were further stratified by the presence of compensated versus decompensated cirrhosis. Validated ICD-9 codes captured patients and surgical procedures. Multivariate logistic regression models were fit. The primary outcomes of interest were mortality and surgical intervention rates. RESULTS: There were 1,555,469 patients hospitalized for diverticulitis without cirrhosis, and 7523 patients hospitalized for diverticulitis with cirrhosis. On multivariate analysis, patients with cirrhosis had an increased mortality rate (OR 2.28; 95% CI 1.48-3.5). There were no significant differences in surgical interventions. Subgroup multivariate analyses of compensated cirrhosis (n = 6170) and decompensated cirrhosis (n = 1353) revealed that decompensated cirrhosis had an increased mortality rate (OR 4.99; 95% CI 2.48-10.03) when compared to patients without cirrhosis, whereas those with compensated cirrhosis did not (OR 1.67; 95% CI 0.96-2.91). Those with compensated cirrhosis underwent less surgical interventions (OR 0.82; 95% CI 0.67-0.99) compared to those without cirrhosis. Patients with diverticulitis and cirrhosis had increased costs and lengths of hospitalization. CONCLUSION: Presence of cirrhosis in patients hospitalized for diverticulitis is associated with an increased mortality rate. These are novel findings, and future clinical studies should focus on improving diverticulitis outcomes in this group.
BACKGROUND:Diverticulitis in patients with cirrhosis has been associated with higher surgical mortality, but no prior studies evaluate non-surgical treatment results. AIMS: Our aim was to compare the outcomes of hospitalization for diverticulitis in patients with and without cirrhosis. METHODS: We utilized the Nationwide Inpatient Sample (2007-2013) for patients with and without cirrhosis hospitalized for diverticulitis. Patients were further stratified by the presence of compensated versus decompensated cirrhosis. Validated ICD-9 codes captured patients and surgical procedures. Multivariate logistic regression models were fit. The primary outcomes of interest were mortality and surgical intervention rates. RESULTS: There were 1,555,469 patients hospitalized for diverticulitis without cirrhosis, and 7523 patients hospitalized for diverticulitis with cirrhosis. On multivariate analysis, patients with cirrhosis had an increased mortality rate (OR 2.28; 95% CI 1.48-3.5). There were no significant differences in surgical interventions. Subgroup multivariate analyses of compensated cirrhosis (n = 6170) and decompensated cirrhosis (n = 1353) revealed that decompensated cirrhosis had an increased mortality rate (OR 4.99; 95% CI 2.48-10.03) when compared to patients without cirrhosis, whereas those with compensated cirrhosis did not (OR 1.67; 95% CI 0.96-2.91). Those with compensated cirrhosis underwent less surgical interventions (OR 0.82; 95% CI 0.67-0.99) compared to those without cirrhosis. Patients with diverticulitis and cirrhosis had increased costs and lengths of hospitalization. CONCLUSION: Presence of cirrhosis in patients hospitalized for diverticulitis is associated with an increased mortality rate. These are novel findings, and future clinical studies should focus on improving diverticulitis outcomes in this group.
Authors: Sven Richter; Werner Lindemann; Otto Kollmar; Georg A Pistorius; Christoph A Maurer; Martin K Schilling Journal: World J Surg Date: 2006-06 Impact factor: 3.352
Authors: Hossein Masoomi; Brian Buchberg; Brian Nguyen; Vicrumdeep Tung; Michael J Stamos; Steven Mills Journal: World J Surg Date: 2011-09 Impact factor: 3.352