title: Outpatient treatment for acute uncomplicated diverticulitis.
abstract: BACKGROUND
  Traditionally, treatment of acute diverticulitis has mostly been based on inpatient care. The question arises whether these patients can be treated on an outpatient basis as the admissions for diverticular disease have been shown to be increasing every year. We studied whether outpatient treatment of acute uncomplicated diverticulitis is feasible and safe, and which patients could benefit from outpatient care.
  
  
  METHODS
  A retrospective cohort study was carried out in two teaching hospitals using hospital registry codes for diverticulitis. All patients diagnosed with acute uncomplicated diverticulitis between January 2004 and January 2012, confirmed by imaging or colonoscopy, were included. Exclusion criteria were patients with recurrent diverticulitis, complicated diverticulitis (Hinchey stages 2, 3, and 4), and right-sided diverticulitis. Inpatient care was compared with outpatient care. Primary outcome was admission for outpatient care and the complication rate in both groups. Multivariate analysis was carried out to identify potential factors for inpatient care.
  
  
  RESULTS
  Of 627 patients with diverticulitis, a total of 312 consecutive patients were identified with primary uncomplicated diverticulitis of the sigmoid colon; 194 patients had been treated as inpatients and 118 patients primarily as outpatients. In this last group, 91.5% had been treated successfully without diverticulitis-related complications or the need for hospital admission during a mean follow-up period of 48 months.
  
  
  CONCLUSIONS
  Despite inherent patient selection in a retrospective cohort, ambulatory treatment of patients presenting with uncomplicated acute diverticulitis seems feasible and safe. In mildly ill and younger patients, hospital admission can be avoided.
authors: aDepartment of Surgery, Sint Lucas Andreas Hospital bDepartment of Surgery, Onze Lieve Vrouwe Gasthuis cDepartment of Surgery, Academic Medical Centre, Amsterdam, The Netherlands.
authors: Çagdas
authors: Ç
authors: Ünlü
authors: Patrick M
authors: PM
authors: Gunadi
authors: Michael F
authors: MF
authors: Gerhards
authors: Marja A
authors: MA
authors: Boermeester
authors: Bart C
authors: BC
authors: Vrouenraets
mesh_terms: D000208:Acute Disease; D061605:Administration, Intravenous; D000284:Administration, Oral; D000328:Adult; D000367:Age Factors; D000368:Aged; D000553:Ambulatory Care; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016009:Chi-Square Distribution; D004238:Diverticulitis / Q000175:diagnosis / Q000188:drug therapy*; D004334:Drug Administration Schedule; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D010343:Patient Admission; D018579:Patient Selection; D012042:Registries; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents