Characteristics and Treatment Outcomes of Colonic Diverticulitis in Hospitalized Patients in Thailand.

Background: Colonic diverticular disease exhibits mucosal outpouchings through the large intestine. Common complications of this disease are diverticular bleeding and diverticulitis. The prevalence of the disease is age-dependent, and some patients with diverticulitis develop complications especially the elderly, the obese and those with co-morbid diseases. In a retrospective study in Chiang Mai, Thailand, the mortality rate was 3.6% at 30 days and 9.2% at 1 year.

Objective: To determine the financial burden, clinical characteristics and factors associated with severity and mortality of patients with colonic diverticulitis.

Material And Method: This was a retrospective study of in-patients from hospitals nationwide, and data were retrieved from three major health care system databases in the fiscal year 2010, searching for ICD code 10. Patients diagnosed with diverticular disease of the large intestine were included in this study, and baseline characteristics and clinical outcomes were analyzed. The study was approved by the institutional ethics committee of Rajavithi Hospital.

Results: One thousand seven hundred and fifty patients with colonic diverticulitis were enrolled in the study and their data were analyzed. The mean age of the patients was 61.15+16.12 years old, about 70% of patients had co-morbid diseases, and the incidence of complicated colonic diverticulitis was 14.51%. The median length of hospital stay (LOS) was 6 days, half of the patients underwent surgery, and the mortality rate was 3.26%. Multivariate regression analysis revealed that the parameters associated with disease severity were number of co-morbid diseases, the universal coverage health care system, and surgical treatment, while the parameters associated with mortality were having more than two co-morbid diseases and being in the universal coverage health care system.

Conclusion: Colonic diverticulitis was common in elderly patients and associated with co-morbid diseases. Most patients had mild severity but a high rate of surgery, and the mortality rate was higher than in western countries. Parameters associated with disease severity and mortality were having co-morbid disease, being in the universal coverage healthcare system and having surgical treatment.