title: Characteristics of Colonic Diverticulitis and Factors Associated With Complications: A Japanese Multicenter, Retrospective, Cross-Sectional Study.
abstract: BACKGROUND
  Little is known about the epidemiology of diverticulitis in Japan. Additional information is needed about its clinical characteristics and the factors associated with complications of diverticulitis.
  
  
  OBJECTIVE
  This study was designed to determine the clinical characteristics of diverticulitis and factors associated with its complications in Japanese patients.
  
  
  METHODS
  This was a retrospective, multicenter, large-scale, cross-sectional study.
  
  
  METHODS
  All of the consecutive patients in 21 Japanese hospitals with a final diagnosis of acute colonic diverticulitis were included in this study.
  
  
  METHODS
  A total of 1112 patients, including 658 men and 454 women, with a mean age of 54.8 years, who were diagnosed by CT and/or ultrasonography between January 2006 and May 2011, were included in this study.
  
  
  METHODS
  Data on medical history, investigations, treatments, and prognosis were collected using a standard form to create a dedicated database.
  
  
  METHODS
  Clarification of the clinical characteristics of Japanese patients with acute diverticulitis was the main outcome measured.
  
  
  RESULTS
  Diverticulitis was detected mainly in men and women aged 40 to 60 years. Although diverticulitis more frequently affected the right colon (70.1%), diverticulitis of the left colon was significantly more frequent (61.0%) in elderly patients. Of the 1112 patients with diverticulitis, 179 (16.1%) developed complications, including abscess formation, perforation, stenosis, and/or fistula, some of which required surgical treatment, such as drainage or colonic resection. The duration of hospitalization (24.1 ± 19.5 days) and mortality rate (2.8%) were significantly higher in patients with versus without complications. Factors associated with complications were fever (>38.5°C), involvement of the left colon, higher age, and delayed diagnosis.
  
  
  CONCLUSIONS
  Limitations included the nonconsideration of diverticulitis treatment, the effect of dietary fiber, and the retrospective design of the study.
  
  
  CONCLUSIONS
  Complications were more frequent in elderly men with left-sided diverticulitis, although diverticulitis was more common in middle-aged people and on the right side of the colon. Factors associated with complications were fever, site of involvement, older age, and longer time until diagnosis.
authors.affiliation: 1 Division of Endoscopy and Ultrasonography, Department of Clinical Pathology and Laboratory Medicine, Kawasaki Medical School, Kurashiki, Japan 2 Department of General Internal Medicine 2, Kawasaki Hospital, Kawasaki Medical School, Okayama, Japan 3 Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, Yokohama, Japan 4 Department of Gastroenterology, Hamamatsu Medical Center, Hamamatsu, Japan 5 Division of Gastroenterology, Fujieda Municipal General Hospital, Fujieda, Japan 6 Medical Examination Center of Chubu Medical Association, Chatan-cho, Japan 7 Department of Internal Medicine, Teikyo University School of Medicine, Tokyo, Japan.
authors.forename: Noriaki
authors.initials: N
authors.lastname: Manabe
authors.forename: Ken
authors.initials: K
authors.lastname: Haruma
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakajima
authors.forename: Masami
authors.initials: M
authors.lastname: Yamada
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Maruyama
authors.forename: Masanori
authors.initials: M
authors.lastname: Gushimiyagi
authors.forename: Takatsugu
authors.initials: T
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004239:Diverticulitis, Colonic / Q000150:complications* / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors