The use of patient-reported outcome measures in recurrent diverticulitis

National guidelines for elective colectomy for uncomplicated diverticulitis have changed to a patient-centered approach. Patient-reported outcome measures, such as the Diverticulitis Quality of Life Instrument, may be helpful to determine who will benefit from elective colectomy for diverticulitis.

We performed a prospective observational cohort study to investigate whether greater Diverticulitis Quality of Life Instrument scores (indicating more severe disease burden) would be associated with increased likelihood of electing to undergo colectomy for recurrent diverticulitis. Adult patients ≥18 year old seen in consultation for uncomplicated diverticulitis at a tertiary referral medical center from March 2021 to August 2023 were included for analysis. The primary outcome of interest was the decision to proceed with elective colectomy vs. continued medical management.

Of the 70 patients included, 48 (68.6%) elected for medical management and 22 (31.4%) had elective surgery planned or completed during the study period. The mean overall Diverticulitis Quality of Life Instrument scores were 4.6 (standard deviation, 1.8) for the medical management group and 5.3 (standard deviation, 1.2) for the elective colectomy group. An adjusted multivariable analysis showed an odds ratio of 1.39 (confidence interval, 1.03-1.89, P = .04) for electing surgical management with one-unit greater baseline Diverticulitis Quality of Life Instrument overall score and an odds ratio of 1.36 (confidence interval, 1.03-1.78, P = .03) for one-unit greater baseline Diverticulitis Quality of Life Instrument score in the subdomain of behavior.

We observed significantly greater baseline overall Diverticulitis Quality of Life Instrument scores and scores in the subdomain of behavior in patients who chose to pursue elective colectomy after consultation for recurrent diverticulitis.