Risk factors for emergency surgery for diverticulitis: A retrospective multicentric French study at 41 hospitals

Area of Science:

• Gastroenterology
• Surgical Oncology
• Epidemiology

Background:

• Complicated diverticulitis incidence is rising, potentially increasing emergency surgeries.
• Sigmoid diverticulitis management requires understanding emergency surgical rates and predictors.

Purpose of the Study:

• To determine the rate of emergency surgery for sigmoid diverticulitis.
• To identify independent risk factors associated with emergency surgical intervention for sigmoid diverticulitis.

Main Methods:

• Retrospective analysis of 6,867 patients undergoing sigmoid diverticulitis surgery (2010-2021).
• Mixed logistic regression with multiple imputation was used to identify risk factors.
• Urgent vs. elective surgery classification was surgeon-determined.

Main Results:

• One-third (33%) of surgeries for sigmoid diverticulitis were emergencies.
• Independent risk factors for emergency surgery included advanced age, low BMI (<18.5 kg/m²), neurologic/pulmonary comorbidities, anticoagulant use, immunocompromised status, and first diverticulitis attack.
• Post-2017 national guidelines, emergency surgery likelihood increased only for patients with prior attacks.

Conclusions:

• A significant proportion of sigmoid diverticulitis surgeries are emergencies (33%).
• Patient characteristics and a first-time diverticulitis attack are key predictors of emergency surgery.
• Understanding these factors can aid in optimizing surgical management strategies.