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Published on: July 12, 2018
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Conditional risk of diverticulitis after non-operative management
R Garfinkle1, T Almalki1, V Pelsser2
1Division of Colon and Rectal Surgery, Montreal, Quebec, Canada.
The British Journal of Surgery
|September 3, 2020
Summary
Recurrence-free survival (RFS) for diverticulitis improves annually for patients not undergoing surgery. While initial risk factors like age and comorbidities influence early recurrence, their impact diminishes over time.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Epidemiology
Background:
- Diverticulitis recurrence impacts patient management and outcomes.
- Understanding conditional recurrence-free survival (RFS) is crucial for non-surgical management.
- Identifying risk factors for diverticulitis recurrence is essential.
Purpose of the Study:
- To describe conditional RFS in patients with diverticulitis managed non-surgically.
- To estimate differences in conditional RFS based on specific risk factors.
Main Methods:
- Multicentre retrospective cohort study of 991 patients with acute sigmoid diverticulitis.
- Non-surgical management at two university-affiliated hospitals in Montreal, Canada.
- Cox proportional hazards models used to assess RFS at index and 2-year follow-up.
Main Results:
- 1, 2, and 3-year actuarial RFS rates were 81.1%, 71.5%, and 67.5%.
- Conditional 1-year RFS reached 96.0% after 4 recurrence-free years.
- Lower age, high Charlson Co-morbidity Index, and immunosuppression were associated with early recurrence.
Conclusions:
- Conditional RFS for diverticulitis improves with each recurrence-free year.
- Initial risk factors' association with recurrence lessens over time.
- Non-surgical management outcomes can be predicted with improved accuracy over time.
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