20-Year Trends in the Management of Diverticulitis Across New York State: an Analysis of 265,724 Patients

Ryan Lamm, Steven N. Mathews, Jie Yang, Lijuan Kang, Dana Telem, Aurora D. Pryor, Mark Talamini, Jill Genua

Research output: Contribution to journalArticle

Abstract

Introduction: Management of acute diverticulitis (AD) has considerably changed over time. This study evaluates practice patterns for diverticulitis across demographic populations in New York State. Methods: Two hundred sixty-five thousand seven hundred twenty-four patients with acute diverticulitis were analyzed from 1995 to 2014 from the New York-Statewide Planning and Research Cooperative System database. The likelihood of having surgery over time was compared across patient demographic subgroups using logistic regression models to calculate estimated odds ratio with their 95 % confidence intervals. Using Chi-square test and Welch’s t test, categorical and continuous variables were compared. Results: From 1995 to 2014, there was an increase in newly diagnosed diverticulitis patients while the proportion of those patients undergoing operative management steadily decreased (31 to 10 %, p <0.0001). Of those receiving surgery, emergent surgeries decreased (58 to 47 %, p <0.0001) while elective surgeries increased (42 to 53 %, p <0.0001) with the odds of having emergency surgery decreasing by 4 % annually (OR 0.96 (0.95–0.97), p <0.0001). With the exception of patients greater than 80 years old, these linear trends were substantiated across patient subgroups. Conclusions: Over the past 20 years in New York State, there has been an increase in diverticulitis diagnoses and hospital admissions, with a decrease in surgeries performed reflecting a shift towards conservative management and more effective antibiotic treatment.

Original languageEnglish (US)
Pages (from-to)1-7
Number of pages7
JournalJournal of Gastrointestinal Surgery
DOIs
StateAccepted/In press - Jul 25 2016
Externally publishedYes

Fingerprint

Diverticulitis
Logistic Models
Demography
Chi-Square Distribution
Emergencies
Odds Ratio
Databases
Confidence Intervals
Anti-Bacterial Agents
Research
Population

Keywords

  • Diverticular
  • Diverticulitis
  • Management

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology

Cite this

20-Year Trends in the Management of Diverticulitis Across New York State : an Analysis of 265,724 Patients. / Lamm, Ryan; Mathews, Steven N.; Yang, Jie; Kang, Lijuan; Telem, Dana; Pryor, Aurora D.; Talamini, Mark; Genua, Jill.

In: Journal of Gastrointestinal Surgery, 25.07.2016, p. 1-7.

Research output: Contribution to journalArticle

Lamm, Ryan ; Mathews, Steven N. ; Yang, Jie ; Kang, Lijuan ; Telem, Dana ; Pryor, Aurora D. ; Talamini, Mark ; Genua, Jill. / 20-Year Trends in the Management of Diverticulitis Across New York State : an Analysis of 265,724 Patients. In: Journal of Gastrointestinal Surgery. 2016 ; pp. 1-7.
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abstract = "Introduction: Management of acute diverticulitis (AD) has considerably changed over time. This study evaluates practice patterns for diverticulitis across demographic populations in New York State. Methods: Two hundred sixty-five thousand seven hundred twenty-four patients with acute diverticulitis were analyzed from 1995 to 2014 from the New York-Statewide Planning and Research Cooperative System database. The likelihood of having surgery over time was compared across patient demographic subgroups using logistic regression models to calculate estimated odds ratio with their 95 {\%} confidence intervals. Using Chi-square test and Welch’s t test, categorical and continuous variables were compared. Results: From 1995 to 2014, there was an increase in newly diagnosed diverticulitis patients while the proportion of those patients undergoing operative management steadily decreased (31 to 10 {\%}, p <0.0001). Of those receiving surgery, emergent surgeries decreased (58 to 47 {\%}, p <0.0001) while elective surgeries increased (42 to 53 {\%}, p <0.0001) with the odds of having emergency surgery decreasing by 4 {\%} annually (OR 0.96 (0.95–0.97), p <0.0001). With the exception of patients greater than 80 years old, these linear trends were substantiated across patient subgroups. Conclusions: Over the past 20 years in New York State, there has been an increase in diverticulitis diagnoses and hospital admissions, with a decrease in surgeries performed reflecting a shift towards conservative management and more effective antibiotic treatment.",
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