title: Recurrence and virulence of colonic diverticulitis in immunocompromised patients.
abstract: BACKGROUND
  To evaluate the probability of recurrence and the virulence of colonic diverticulitis correlated with immunocompromised status.
  
  
  METHODS
  Nine hundred thirty-one patients admitted in a single tertiary referral university hospital over a 14-year period were included. Patients were divided into 2 groups: group 1, 166 immunosuppressed patients, and group 2, 765 nonimmunosuppressed patients. The variables studied were sex, age, American Society of Anesthesiologist status, reasons of immunosuppression (eg, chronic use of corticosteroids, transplant recipients, and diseases affecting the immune system), severity of the diverticulitis episode, recurrence, emergency and elective surgery, and morbidity and mortality rates.
  
  
  RESULTS
  Two hundred thirteen patients underwent an emergency operation during the first hospitalization and 26 patients in further episodes. One hundred thirty-six patients developed 1 or more recurrent episodes of diverticulitis. The overall recurrence rate was similar in both groups. Patients in group 1 with a severe first episode presented significantly higher rates of recurrence and severity without needing more emergency surgery. Mortality after emergency surgery was 33.3% in group 1 and 15.9% in group 2 (P = .004).
  
  
  CONCLUSIONS
  After successful medical treatment of acute diverticulitis, patients with immunosuppression need not be advised to have an elective sigmoidectomy.
authors.affiliation: Department of General and Digestive Surgery, Colorectal Unit, C. Feixa Llarga S/n, L'Hospitalet de Llobregat, 08907 Barcelona, Spain. sbn.biondo@gmail.com
authors.forename: Sebastiano
authors.initials: S
authors.lastname: Biondo
authors.forename: Jaime Lopez
authors.initials: JL
authors.lastname: Borao
authors.forename: Esther
authors.initials: E
authors.lastname: Kreisler
authors.forename: Thomas
authors.initials: T
authors.lastname: Golda
authors.forename: Monica
authors.initials: M
authors.lastname: Millan
authors.forename: Ricardo
authors.initials: R
authors.lastname: Frago
authors.forename: Domenico
authors.initials: D
authors.lastname: Fraccalvieri
authors.forename: Jordi
authors.initials: J
authors.lastname: Guardiola
authors.forename: Eduardo
authors.initials: E
authors.lastname: Jaurrieta
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004032:Diet; D013505:Digestive System Surgical Procedures / Q000706:statistics & numerical data; D004239:Diverticulitis, Colonic / Q000453:epidemiology / Q000628:therapy*; D004630:Emergencies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016867:Immunocompromised Host; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012146:Rest; D012720:Severity of Illness Index
chemical_list: D000900:Anti-Bacterial Agents