title: A comparison of outcomes of emergent, urgent, and elective surgical treatment of diverticulitis.
abstract: BACKGROUND
  There is a controversy regarding the best urgent surgical treatment of colonic diverticulitis. We sought to compare outcomes of patients who underwent surgery for diverticulitis by the type of admission.
  
  
  METHODS
  The National Surgical Quality Improvement Program databases were used to examine the clinical data of patients who underwent colorectal resection for diverticulitis during 2012 to 2013. Multivariate regression analysis was performed to identify outcomes of patients.
  
  
  RESULTS
  We sampled a total of 13,510 patients admitted for diverticulitis who underwent colorectal resection, of which 7.8% had emergent and 19.7% had urgent operation. Patients with perforation (adjusted odds ratio [AOR] 188.56, P < .01) and preoperative sepsis (AOR 28.17, P < .01) had significantly higher rates of emergent surgery. Patients who underwent emergent operation had higher mortality (AOR 4.08, P = .04) and morbidity (AOR 2.14, P < .01). Emergent operations had a significantly higher risk of anastomosis leakage compared with elective operation (AOR 3.92, P = .02).
  
  
  CONCLUSIONS
  Emergent treatment of diverticulitis is associated with a high morbidity and mortality. In the setting of emergent treatment of diverticulitis, colonic anastomosis without a stoma has a high risk of anastomosis leakage.
authors.affiliation: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, CA, USA.
authors.forename: Zhobin
authors.initials: Z
authors.lastname: Moghadamyeghaneh
authors.affiliation: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, CA, USA.
authors.forename: Joseph C
authors.initials: JC
authors.lastname: Carmichael
authors.affiliation: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, CA, USA.
authors.forename: Brian R
authors.initials: BR
authors.lastname: Smith
authors.affiliation: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, CA, USA.
authors.forename: Steven
authors.initials: S
authors.lastname: Mills
authors.affiliation: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, CA, USA.
authors.forename: Alessio
authors.initials: A
authors.lastname: Pigazzi
authors.affiliation: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, CA, USA.
authors.forename: Ninh T
authors.initials: NT
authors.lastname: Nguyen
authors.affiliation: Department of Surgery, University of California, Irvine, School of Medicine, Irvine, CA, USA. Electronic address: mstamos@uci.edu.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Stamos
mesh_terms: D057868:Anastomotic Leak / Q000453:epidemiology; D001201:Ascites / Q000453:epidemiology / Q000601:surgery; D003106:Colon / Q000601:surgery; D003125:Colostomy / Q000706:statistics & numerical data; D016208:Databases, Factual; D004239:Diverticulitis, Colonic / Q000453:epidemiology / Q000601:surgery*; D017558:Elective Surgical Procedures / Q000706:statistics & numerical data*; D004630:Emergencies; D005260:Female; D006801:Humans; D007416:Intestinal Perforation / Q000453:epidemiology / Q000601:surgery; D010535:Laparoscopy; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D018805:Sepsis / Q000453:epidemiology; D014481:United States / Q000453:epidemiology
keywords: Colonic diverticulitis; Diverticulitis; Emergent surgical treatment