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

被引:72
作者
Jeyarajah, S. [1 ]
Faiz, O. [2 ]
Bottle, A. [3 ]
Aylin, P. [3 ]
Bjarnason, I. [4 ]
Tekkis, P. P. [2 ]
Papagrigoriadis, S. [1 ]
机构
[1] Kings Coll Hosp London, Dept Colorectal Surg, London SE5 9RS, England
[2] Univ London Imperial Coll Sci Technol & Med, Dept Biosurg & Surg Technol, London, England
[3] Univ London Imperial Coll Sci Technol & Med, Dept Epidemiol, London, England
[4] Kings Coll Hosp London, Dept Gastroenterol, London SE5 9RS, England
关键词
SIGMOID DIVERTICULITIS; ADMINISTRATIVE DATA; COLON; SURGERY; RISK; MORTALITY; MEN; COMPLICATIONS; PERFORMANCE; DATABASE;
D O I
10.1111/j.1365-2036.2009.04098.x
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
P>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.
引用
收藏
页码:1171 / 1182
页数:12
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