Defining diverticular fistula through inpatient admissions: a population study

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Diverticular fistula, an abnormal connection from the colon, is an uncommon complication of diverticular disease.
• It is typically an indication for surgical intervention.
• Limited data exists on the epidemiology of fistulous diverticular disease.

Purpose of the Study:

• To define the demographics of patients with fistulous diverticular disease on a national level.
• To compare demographic factors between patients with fistulizing and non-fistulizing diverticular disease.
• To analyze treatment patterns, including surgical intervention rates.

Main Methods:

• Retrospective review of the 2018 National Inpatient Sample (NIS).
• Utilized ICD-10 codes for diverticular disease, fistulas, and surgeries.
• Compared demographic factors and performed subgroup analyses.

Main Results:

• Diverticular fistula accounted for 0.05% of all admissions.
• Patients with fistula were younger (64.7 vs. 68.2 years) and more likely female (57.3% vs. 55.4%).
• Fistula patients had higher surgery rates (64.9% vs. 25.7%), elective admission rates (44.7% vs. 12.0%), and longer lengths of stay (8.07 vs. 5.20 days).

Conclusions:

• Diverticular fistula is a rare but more prevalent diagnosis than previously reported.
• Despite surgical indication, only 64.9% of patients received surgical treatment.
• This study provides national-level insights into the prevalence and inpatient admission patterns of diverticular fistula.