title: Cigarette smoking and appendectomy: effect on clinical course of diverticulosis.
abstract: 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.
authors.affiliation: Department of Internal Medicine, Cagliari University, AOU Policlinico di Monserrato 09042, Monserrato, Italy. usaip@medicina.unica.it
authors.forename: Paolo
authors.initials: P
authors.lastname: Usai
authors.forename: Ivan
authors.initials: I
authors.lastname: Ibba
authors.forename: Mariantonia
authors.initials: M
authors.lastname: Lai
authors.forename: Maria Francesca
authors.initials: MF
authors.lastname: Boi
authors.forename: Maria Flavia
authors.initials: MF
authors.lastname: Savarese
authors.forename: Rosario
authors.initials: R
authors.lastname: Cuomo
authors.forename: Giuseppe
authors.initials: G
authors.lastname: D'Alia
authors.forename: Sergio
authors.initials: S
authors.lastname: Gemini
authors.forename: Giacomo
authors.initials: G
authors.lastname: Diaz
authors.forename: Paolo
authors.initials: P
authors.lastname: Contu
mesh_terms: 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*