Diverticular disease increases and effects younger ages: an epidemiological study of 10-year trends.
BACKGROUND
Little data exists on epidemiological trends of diverticular disease (DD). This study of 2,979 admissions over 10 years aimed to examine the epidemiological trends of DD admissions and clinical outcomes.


METHODS
A retrospective analysis of all admissions with DD from 1995 to 2004 was performed. General population data for the area was obtained from the national Census and local primary care trust.


RESULTS
Annual admissions for DD increased from 71 to 263 (p = 0.000). There was a trend of decreasing mean age from 71.2 years in 1995 to 68.1 in 2004 (p = 0.06). Admissions younger than 50 years increased from eight in 1995 to 42 in 2003 (p = 0.005). The mean age and size of the catchment population remained stable in that time. More emergency admissions underwent surgery (14.4%, n = 54) than electives (6.1%, n = 66) and had longer lengths of stay (25.2 vs. 9.2 days; p = 0.000). More patients under 50 (19.6%, n = 21) had surgery compared with older ones (8.8%, n = 100; p = 0.000). Recurrent admissions increased from 18 to 72 per year (p = 0.000) but were not associated with poor clinical outcomes. There were 21 deaths overall. Deaths were more likely in emergencies (p = 0.000, OR = 56.42) and those aged over 80 (p = 0.000, OR = 2.87). Mortality was independent of co-morbidity and other demographic factors.


CONCLUSIONS
DD admissions increased, unexplained by an ageing population, increasingly affecting younger patients who are more likely to undergo surgery, particularly as emergencies. Emergency admissions are associated with longer stay and higher mortality. Recurrent admission cannot be used as guide to elective surgery. Efforts should be made to treat more DD electively.
Jeyarajah
Santhini
S
Colorectal Surgery, King's College Hospital, London, UK. sanjeyarajah@doctors.net.uk
Papagrigoriadis
Savvas
S
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D004240:Diverticulum / Q000150:complications / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D008875:Middle Aged; D015996:Survival Rate; D006113:United Kingdom / Q000453:epidemiology