title: Outcomes and costs of elective surgery for diverticular disease: a comparison with other diseases requiring colectomy.
abstract: OBJECTIVE
  To compare outcomes and costs of elective surgery for diverticular disease (DD) with those of other diseases commonly requiring colectomy.
  
  
  METHODS
  Multivariable analyses using the Nationwide Inpatient Sample to compare outcomes across primary diagnosis while adjusting for age, sex, race, year of admission, and comorbid disease.
  
  
  METHODS
  A sample of US hospital admissions from 2003-2009.
  
  
  METHODS
  All adult patients (≥18 years) undergoing elective resection of the descending colon or subtotal colectomy who had a primary diagnosis of DD, colon cancer (CC), or inflammatory bowel disease (IBD).
  
  
  METHODS
  In-hospital mortality, postoperative complications, ostomy placement, length of stay, and hospital charges.
  
  
  RESULTS
  Of the 74,879 patients, 50.52% had DD, 43.48% had CC, and 6.00% had IBD. After adjusting for other variables, patients with DD were significantly more likely than patients with CC to experience in-hospital mortality (adjusted odds ratio, 1.90; 95% CI, 1.37-2.63; P < .001), develop a postoperative infection (1.67; 1.48-1.89; P < .001), and have an ostomy placed (1.87; 1.65-2.11; P < .001). The adjusted total hospital charges for patients with DD were $6678.78 higher (95% CI, $5722.12-$7635.43; P < .001) and length of stay was 1 day longer (95% CI, 0.86-1.14; P < .001) compared with patients with CC. Patients with IBD had the highest in-hospital mortality, highest rates of complications and ostomy placement, longest length of stay, and highest hospital charges.
  
  
  CONCLUSIONS
  Despite undergoing the same procedure, patients with DD have significantly worse and more costly outcomes after elective colectomy compared with patients with CC but better than patients with IBD. These relatively poor outcomes should be recognized when considering routine elective colectomy after successful nonoperative management of acute diverticulitis.
authors.affiliation: Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
authors.forename: Kyle J
authors.initials: KJ
authors.lastname: Van Arendonk
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Tymitz
authors.forename: Susan L
authors.initials: SL
authors.lastname: Gearhart
authors.forename: Miloslawa
authors.initials: M
authors.lastname: Stem
authors.forename: Anne O
authors.initials: AO
authors.lastname: Lidor
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016009:Chi-Square Distribution; D003082:Colectomy / Q000191:economics*; D003110:Colonic Neoplasms / Q000191:economics / Q000601:surgery; D003125:Colostomy / Q000191:economics; D015897:Comorbidity; D004238:Diverticulitis / Q000191:economics* / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000191:economics*; D005260:Female; D017722:Hospital Charges / Q000706:statistics & numerical data; D017052:Hospital Mortality; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000191:economics / Q000601:surgery; D007902:Length of Stay / Q000191:economics; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology; D012189:Retrospective Studies; D014481:United States / Q000453:epidemiology