title: Trends in diverticulitis management in the United States from 2002 to 2007.
abstract: OBJECTIVE
  To demonstrate the recent trends of admission and surgical management for diverticulitis in the United States.
  
  
  METHODS
  Retrospective database analysis.
  
  
  METHODS
  The National Inpatient Sample database.
  
  
  METHODS
  Patients admitted to the hospital for diverticulitis from 2002 to 2007.
  
  
  METHODS
  Patient characteristics, surgical approach, and mortality were evaluated for elective or emergent admission.
  
  
  RESULTS
  A total of 1,073,397 patients were admitted with diverticulitis (emergent: 78.3%, elective: 21.7%). The emergent admission rate increased by 9.5% over the study period. For emergent patients, 12.2% underwent urgent surgical resection and 87.8% were treated with nonoperative methods (percutaneous abscess drainage: 1.88% and medical treatment: 85.92%). There was only a 4.3% increase in urgent surgical resections, while elective surgical resections increased by 38.7.%. The overall rate of elective laparoscopic colon resection was 10.5%. Elective laparoscopic surgery nearly doubled from 6.9% in 2002 to 13.5% in 2007 (P < .001). Primary anastomosis rates increased for elective resections over time (92.1% in 2002 to 94.5% in 2007; P < .001). For urgent open operation, use of colostomy decreased significantly from 61.2% in 2002 to 54.0% in 2007 (P < .001). In-hospital mortality significantly decreased in both elective and urgent surgery (elective: 0.53% in 2002 to 0.44% in 2007; P = .001; urgent: 4.5% in 2002 to 2.5% in 2007; P < .001).
  
  
  CONCLUSIONS
  Diverticulitis continues to be a source of significant morbidity in the United States. However, our data show a trend toward increased use of laparoscopic techniques for elective operations and primary anastomosis for urgent operations.
authors.affiliation: University of California, Irvine, Department of Surgery and Division of Colon and Rectal Surgery, 333 City Blvd West, Ste 850, Orange, CA 92868, USA.
authors.forename: Hossein
authors.initials: H
authors.lastname: Masoomi
authors.forename: Brian S
authors.initials: BS
authors.lastname: Buchberg
authors.forename: Cheryl
authors.initials: C
authors.lastname: Magno
authors.forename: Steven D
authors.initials: SD
authors.lastname: Mills
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000714:Anastomosis, Surgical / Q000706:statistics & numerical data; D003082:Colectomy / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data* / Q000639:trends; D003125:Colostomy / Q000401:mortality / Q000706:statistics & numerical data* / Q000639:trends; D016208:Databases, Factual; D004238:Diverticulitis / Q000453:epidemiology / Q000601:surgery / Q000628:therapy*; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data; D004630:Emergencies; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D015994:Incidence; D010535:Laparoscopy / Q000401:mortality / Q000706:statistics & numerical data* / Q000639:trends; D007902:Length of Stay; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D015999:Multivariate Analysis; D010343:Patient Admission / Q000706:statistics & numerical data* / Q000639:trends; D012008:Recurrence; D012189:Retrospective Studies; D015996:Survival Rate; D014481:United States / Q000453:epidemiology