title: Diverticulitis in young versus elderly patients: a meta-analysis.
abstract: OBJECTIVE
  To compare patients younger and older than 50 years with diverticulitis with regard to complications, disease recurrence and to the need for surgery.
  
  
  METHODS
  A literature review and meta-analysis was conducted according to the PRISMA guidelines. MEDLINE, Embase and the Cochrane databases were searched for longitudinal cohort studies comparing patients younger and older than 50 years with diverticulitis.
  
  
  RESULTS
  Eight studies were included with a total of 4.751 (male:female 1:0.66) patients younger and 18.328 (male:female 1:1.67) older than 50 years of age. The risk of developing at least one recurrent episode was significantly higher among patients younger than 50 years (pooled RR 1.73; 95% CI 1.40-2.13) with an estimated cumulative risk of 30% compared with 17.3% in older patients. The risk of requiring surgery during hospitalization for a primary episode of diverticulitis was equal in both age groups (pooled RR 0.99; 95% CI 0.74-1.32) and estimated at approximately 20%. Patients younger than 50 years more frequently required urgent surgery during hospitalization for a subsequent recurrent episode (pooled RR 1.46; 95% CI 1.29-1.66); the cumulative risk was 7.3% in younger and 4.9% in patients older than 50 years.
  
  
  CONCLUSIONS
  Patients younger than 50 years only differ substantially in risk for recurrent disease from patients older than 50 years of age. Although the relative risk for requiring urgent surgery for recurrent disease was higher in younger patient, one should consider that the absolute risk difference is relatively small (7.3% vs. 4.9%).
authors: Department of Surgery, Meander Medical Center, Amersfoort, The Netherlands.
authors: Bryan J M
authors: BJ
authors: van de Wall
authors: Jolien A
authors: JA
authors: Poerink
authors: Werner A
authors: WA
authors: Draaisma
authors: Johannes B
authors: JB
authors: Reitsma
authors: Esther C J
authors: EC
authors: Consten
authors: Ivo A M J
authors: IA
authors: Broeders
mesh_terms: D018784:Abdominal Abscess / Q000209:etiology*; D000367:Age Factors; D004238:Diverticulitis / Q000150:complications* / Q000401:mortality / Q000601:surgery*; D004638:Emergency Treatment; D005260:Female; D005402:Fistula / Q000209:etiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012306:Risk