Age-related differences in postoperative outcomes following colectomy for diverticular disease: a National Surgical...

The incidence of diverticular disease in younger adults has been on the rise over the past decades. This study aimed to evaluate the association between age and postoperative outcomes for patients undergoing colectomy for diverticular disease.

A retrospective analysis was performed using the American College of Surgeons National Surgical Quality Improvement Program Participant Use Files between 2016 and 2020. Adults aged ≥18 years who underwent colectomy for diverticular disease were included. Demographic, perioperative, and postoperative variables were analyzed between patients aged <50 and ≥50 years. A multivariable logistic regression was used to identify independent predictors of major intra-abdominal complications, defined as positive when either anastomotic leak or organ/space surgical site infections were present.

A total of 39,729 patients met the inclusion criteria. Younger individuals comprised 23% of the cohort, were less often female (36% vs 61%; P <.001), had a higher mean body mass index (32 vs 29; P <.001), and were more likely to be smokers (28% vs 18%; P <.001). Readmissions were more frequent in older patients (8.5% vs 7.5%; P =.002); however, the median time to first readmission occurred earlier in younger patients (12 vs 15 days; P <.001). In multivariable analysis, among other factors, age younger than 50 years independently increased the risk of major intra-abdominal complications (odds ratio, 1.14; 95% CI, 1.02-1.27).

Despite their overall healthier profile, younger patients experience comparable postoperative risk rates with older patients and are at an increased risk of severe intra-abdominal complications. These findings provide insights that add to patient-physician shared decision making.