AI Article Synopsis
- The study investigates the complications and blood transfusion needs associated with diverticulitis and diverticular bleeding in patients with varying levels of kidney function, specifically comparing those with normal to moderately reduced kidney function (GFR ≥ 30 mL/min) to those with severe renal impairment (GFR < 30 mL/min).
- It found that patients with lower kidney function experienced significantly higher rates of complications such as perforations and abscesses as well as greater transfusion requirements, highlighting the increased risk associated with severe renal impairment.
- The research concludes that patients with severe renal impairment not only face more complications but also have longer hospital stays and higher rates of blood transfusions due to diverticular issues compared to those with better kidney function.
Article Abstract
Background: The prevalence of diverticulosis is increasing with 5-10% of patients developing diverticulitis and 5-15% developing symptomatic bleeding. Diverticulitis can result in abscess, perforation, fistula, or obstruction. Bleeding has combined morbidity and mortality rates of 10-20%. The purpose of this study was to compare diverticulitis-related complications and transfusion requirements for diverticular bleeding in patients with normal to moderately reduced kidney function (glomerular filtration rate (GFR) ≥ 30 mL/min/1.73 m) and patients with severe renal impairment (GFR < 30 mL/min/1.73 m), and identify factors associated with these outcomes.
Methods: We retrospectively reviewed records of all patients with diverticulitis and diverticular bleeding treated at our hospital from January 1, 2011 to July 31, 2016. Patients were evaluated for baseline characteristics, GFR, baseline hemoglobin, medications, comorbidities, length of stay (LOS), presence of perforations or abscesses and the need for transfusion.
Results: Of the 291 patients included, males were 167 (58%). Perforations and abscesses complicating diverticulitis developed in 31/136 (23%) of patients with GFR ≥ 30 mL/min/1.73 m, and in 13/26 (50%) of patients with GFR < 30 mL/min/1.73 m (odds ratio (OR): 3.4; 95% confidence interval (CI): 1.423 - 8.06; P = 0.0073). Mean LOS (days) was 6.3 ± 4 in the GFR ≥ 30 mL/min/1.73 m group and 8.5 ± 4.4 in GFR < 30 mL/min/1.73 m group (P = 0.0001). Blood transfusion for diverticular bleeding occurred in 11/78 (14%) of patients with GFR ≥ 30 mL/min/1.73 m and in 22/51 (43%) of patients with GFR < 30 mL/min/1.73 m (OR: 4.6; 95% CI: 1.99 - 10.76; P = 0.0004). Among patients who needed transfusion, mean LOS was 8.5 ± 2.5 in GFR ≥ 30 mL/min/1.73 m group and 9 ± 5 in those with GFR < 30 mL/min/1.73 m (P = 0.04). There were no differences in age, gender or race between the study groups.
Conclusion: There was a significant increase in complicated diverticulitis cases, transfusion requirements for diverticular bleeding and LOS in patients with severely reduced kidney function compared to patients with normal-moderately reduced renal function.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5330688 | PMC |
| http://dx.doi.org/10.14740/gr784w | DOI Listing |
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