Acute and complicated diverticulitis: are there significant differences between young and elderly patients?

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Geriatric Medicine

Background:

• Diverticular disease affects both young and elderly populations.
• Understanding age-related differences in acute diverticulitis is crucial for effective management.
• Previous studies have not consistently differentiated outcomes based on age.

Purpose of the Study:

• To compare clinical presentation, management strategies, and patient outcomes in acute diverticulitis between younger (≤50 years) and elderly (>50 years) cohorts.
• To identify any age-specific variations in disease severity, treatment choices, and recovery.
• To evaluate the long-term prognosis of acute diverticulitis in relation to patient age.

Main Methods:

• Retrospective analysis of 279 patients diagnosed with acute diverticulitis between January 2007 and December 2015.
• Patients were categorized into two groups: young (≤50 years) and elderly (>50 years).
• Key parameters analyzed included demographics, American Society of Anesthesiologists (ASA) score, Hinchey's stage, surgical interventions, morbidity, length of hospital stay, recurrence rates, and overall mortality.

Main Results:

• The study included 279 patients: 64 young (22.9%) and 215 elderly (77.1%).
• Elderly patients exhibited a higher prevalence of female gender and higher ASA scores, correlating with Hinchey's stage.
• While conservative antibiotic therapy was the primary treatment for most patients (82.07%), significant differences were observed in surgical approach (p=0.04), with Hartmann's procedures more common in the elderly.

Conclusions:

• No significant differences were found in Hinchey's stage, timing of surgery, morbidity, length of hospital stay, or recurrence rates between young and elderly patients with acute diverticulitis.
• Hartmann's procedures were performed more frequently in elderly patients, with lower recanalization rates.
• These findings suggest that acute and complicated colonic diverticulitis does not differ significantly in incidence or natural course between age groups, and resection with primary anastomosis may offer the best outcomes with minimal morbidity.