title: Colonic diverticulitis with comorbid diseases may require elective colectomy.
abstract: OBJECTIVE
  To investigate the comorbid disease could be the predictors for the elective colectomy in colonic diverticulitis.
  
  
  METHODS
  A retrospective chart review of 246 patients with colonic diverticulitis admitted between 2000 and 2008 was conducted, and 19 patients received emergent operation were identified and analyzed. Data were collected with regard to age, sex, albumin level on admission, left or right inflammation site, the history of recurrent diverticulitis, preoperative comorbidity, smoking habits, medication, treatment policy, morbidity, and mortality. Preoperative comorbid diseases included cardiovascular disease, diabetes, pulmonary disease, peptic ulcer disease, gouty arthritis, and uremia. Medications in use included non-steroidal anti-inflammatory drugs, acetylsalicylic acid (Aspirin), and corticosteroids. Univariate and multivariate logistic regression analyses were performed to identify the relevant risk factors correlating to colectomy.
  
  
  RESULTS
  The mean age of the 246 patients was 69.5 years (range, 24-94 years). Most diverticulitis could be managed with conservative treatment (n = 227, 92.3%), and urgent colectomy was performed in 19 patients (7.7%). There were three deaths in the surgical group and four deaths in the nonsurgical group. The overall mortality rate in the study was 1.7% among patients with conservative treatment and 15.7% among patients undergoing urgent colectomy. Multiple logistic regression analysis indicated that comorbidities were risk factors for urgent colectomy for diverticulitis.
  
  
  CONCLUSIONS
  To avoid high mortality and morbidity related to urgent colectomy, we suggest that patients with colonic diverticulitis and comorbid diseases may require elective colectomy.
authors.affiliation: Kevin CW Hsiao, Chang-Chieh Wu, Shu-Wen Jao, Division of Colorectal Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan.
authors.forename: Kevin Cw
authors.initials: KC
authors.lastname: Hsiao
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Wann
authors.forename: Chien-Sheng
authors.initials: CS
authors.lastname: Lin
authors.forename: Chang-Chieh
authors.initials: CC
authors.lastname: Wu
authors.forename: Shu-Wen
authors.initials: SW
authors.lastname: Jao
authors.forename: Ming-Hsin
authors.initials: MH
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016009:Chi-Square Distribution; D003082:Colectomy / Q000009:adverse effects / Q000401:mortality; D015897:Comorbidity; D004239:Diverticulitis, Colonic / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D018579:Patient Selection; D012189:Retrospective Studies; D012307:Risk Factors; D013624:Taiwan / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
keywords: Colectomy; Colonic diverticulitis; Comorbid disease