Cigarette smoking and appendectomy: effect on clinical course of diverticulosis.
OBJECTIVE
To investigate the effect of appendectomy and cigarette smoking on the clinical course of diverticulosis.


METHODS
A retrospective case-control study of 207 consecutive patients (45.8% male mean age 64.0 years), 150 with asymptomatic diverticulosis, and 57 with acute diverticulitis. Diagnosis of diverticulosis was defined on the basis of clinical and colonoscopic criteria, diverticulitis was defined by means of clinical, colonoscopic and computerised tomography criteria. Logistic regression function was used to define the relationship between the dependent variable (diverticulitis) and several covariates: sex, age, body mass index, smoking habit, and history of appendectomy.


RESULTS
According to the final model, the risk of diverticulitis was 4.94-fold higher (95% confidence interval: 1.98-12.37) in patients with a history of appendectomy with emergency resection, compared to patients not submitted to appendectomy or with a history of elective resection (P < 0.001); and 2.79-fold higher (95% confidence interval: 1.30-5.96) in smokers than in non-smokers (P = 0.008). The effects of the two determinants were found to be independent, thus the cumulative risk of diverticulitis was 13.78-fold higher for smokers with a history of emergency surgical treatment.


CONCLUSIONS
Smoking and emergency appendectomy are important predictive factors for the clinical course of diverticulosis.
Usai
Paolo
P
Department of Internal Medicine, Cagliari University, AOU Policlinico di Monserrato 09042, Monserrato, Italy. usaip@medicina.unica.it
Ibba
Ivan
I
Lai
Mariantonia
M
Boi
Maria Francesca
MF
Savarese
Maria Flavia
MF
Cuomo
Rosario
R
D'Alia
Giuseppe
G
Gemini
Sergio
S
Diaz
Giacomo
G
Contu
Paolo
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000009:adverse effects*; D016001:Confidence Intervals; D004238:Diverticulitis / Q000175:diagnosis* / Q000209:etiology*; D004240:Diverticulum / Q000150:complications / Q000175:diagnosis*; D004638:Emergency Treatment; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects*