PMID- 29038965
OWN - NLM
STAT- MEDLINE
DCOM- 20180709
LR  - 20181113
IS  - 1432-1262 (Electronic)
IS  - 0179-1958 (Print)
IS  - 0179-1958 (Linking)
VI  - 32
IP  - 12
DP  - 2017 Dec
TI  - Low risk of complications in patients with first-time acute uncomplicated 
      diverticulitis.
PG  - 1699-1702
LID - 10.1007/s00384-017-2912-7 [doi]
AB  - PURPOSE: First-time acute uncomplicated diverticulitis (AUD) has been considered 
      to have an increased risk of complication, but the level of evidence is low. The 
      aim of the present study was to evaluate the risk of complications in patients 
      with first-time AUD and in patients with a history of diverticulitis. METHODS: 
      This paper is a population-based retrospective study at Vastmanland's Hospital, 
      Vasteras, Sweden, where all patients were identified with a diagnosis of colonic 
      diverticular disease ICD-10 K57.0-9 from January 2010 to December 2014. The 
      records of all patients were surveyed and patients with a computed tomography 
      (CT)-verified AUD were included. Complications defined as CT-verified abscess, 
      perforation, colonic obstruction, fistula, or sepsis within 1 month from the 
      diagnosis of AUD were registered. RESULTS: Of 809 patients with AUD, 642 (79%) 
      had first-time AUD and 167 (21%) had a previous history of AUD with no 
      differences in demographic or clinical characteristics. In total, 16 (2%) 
      patients developed a complication within 1 month irrespective of whether they had 
      a previous history of diverticulitis (P = 0.345). In the binary logistic 
      regression analysis, first-time diverticulitis was not associated with increased 
      risk of complications (OR 1.58; CI 0.52-4.81). The rate of antibiotic therapy was 
      about 7-10% during the time period and outpatient management increased from 7% in 
      2010 to 61% in 2014. CONCLUSIONS: The risk for development of complications is 
      low in AUD with no difference between patients with first-time or recurrent 
      diverticulitis. This result strengthens existing evidence on the benign disease 
      course of AUD.
FAU - Chabok, Abbas
AU  - Chabok A
AD  - Departments of Surgery and Centre for Clinical Research, Uppsala University, 
      Vastmanland's Hospital, Vasteras, Sweden. abbas.chabok@regionvastmanland.se.
FAU - Andreasson, Kalle
AU  - Andreasson K
AD  - Departments of Surgery and Centre for Clinical Research, Uppsala University, 
      Vastmanland's Hospital, Vasteras, Sweden.
FAU - Nikberg, Maziar
AU  - Nikberg M
AD  - Departments of Surgery and Centre for Clinical Research, Uppsala University, 
      Vastmanland's Hospital, Vasteras, Sweden.
LA  - eng
PT  - Journal Article
DEP - 20171016
PL  - Germany
TA  - Int J Colorectal Dis
JT  - International journal of colorectal disease
JID - 8607899
RN  - 0 (Anti-Bacterial Agents)
SB  - IM
MH  - Acute Disease
MH  - Aged
MH  - Anti-Bacterial Agents/therapeutic use
MH  - Chi-Square Distribution
MH  - Disease Progression
MH  - Diverticulitis, Colonic/*complications/diagnostic imaging/drug therapy
MH  - Female
MH  - Humans
MH  - Logistic Models
MH  - Male
MH  - Middle Aged
MH  - Multivariate Analysis
MH  - Odds Ratio
MH  - Predictive Value of Tests
MH  - Retrospective Studies
MH  - Risk Factors
MH  - Sweden
MH  - Time Factors
MH  - Tomography, X-Ray Computed
MH  - Treatment Outcome
PMC - PMC5691119
OTO - NOTNLM
OT  - Acute uncomplicated diverticulitis
OT  - Antibiotics
OT  - Diverticulitis
OT  - Outpatient management
OT  - Recurrence
COIS- The study was approved by the Ethics Committee of the Faculty of Medicine, 
      Uppsala University and followed the Declaration of Helsinki guidelines 
      (D.nr2015/213). CONFLICT OF INTEREST: The authors declare that they have no 
      conflict of interest.
EDAT- 2017/10/19 06:00
MHDA- 2018/07/10 06:00
PMCR- 2017/10/16
CRDT- 2017/10/18 06:00
PHST- 2017/09/28 00:00 [accepted]
PHST- 2017/10/19 06:00 [pubmed]
PHST- 2018/07/10 06:00 [medline]
PHST- 2017/10/18 06:00 [entrez]
PHST- 2017/10/16 00:00 [pmc-release]
AID - 10.1007/s00384-017-2912-7 [pii]
AID - 2912 [pii]
AID - 10.1007/s00384-017-2912-7 [doi]
PST - ppublish
SO  - Int J Colorectal Dis. 2017 Dec;32(12):1699-1702. doi: 10.1007/s00384-017-2912-7. 
      Epub 2017 Oct 16.