Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the UK: population-based cohort study. Humes, D. J. & West, J. Gut, 61(1):95--100, January, 2012. doi abstract bibtex OBJECTIVE: To determine the risk of developing complicated colonic diverticular disease (CCDD) with prior episodes of acute diverticulitis and determine the mortality of the spectrum of CCDD. DESIGN: Population-based cohort study. SETTING: Computerised records from the General Practice Research Database linked to Hospital Episode Statistics data from the UK. PARTICIPANTS: Patients and controls registered in the General Practice Research Database from 1990 to 2007. MAIN OUTCOME MEASURES: Mortality was calculated and Cox regression modelling used to provide adjusted HRs and 95% CI. Logistic regression was used to model the effect of prior acute diverticulitis on the development of complications. RESULTS: 2950 patients (1872 (63.5%) female) had a diagnosis of CCDD (8739 controls). A total of 1042 (35.3%) patients died compared with 2062 (23.6%) controls. Most excess deaths occurred in the first year after the complication. Patients with a perforation/abscess had a 4.5-fold increase in 1-year mortality (HR 4.55, 95% CI 3.74 to 5.52) compared with the general population, whereas those with a fistula or stricture had a 2.5-fold increase in mortality (fistula HR 2.60, 95% CI 1.47 to 4.62; stricture HR 2.41, 95% CI 1.86 to 3.11). Although most patients (2133 (72.3%)) had suffered no prior episodes of acute diverticulitis, increasing episodes of acute diverticulitis were associated with an increased risk of developing a fistula (two or more prior episodes, OR 1.54 95%, CI 1.08 to 2.19), but there was no clear relationship with stricture or perforation/abscess. CONCLUSIONS: Although most patients have experienced no prior episodes of acute diverticulitis, fistula formation is preceded by bouts of inflammation. Excess 1-year mortality across the spectrum of CCDD compared with the general population is substantial.
@article{humes_role_2012,
title = {Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the {UK}: population-based cohort study},
volume = {61},
issn = {1468-3288},
shorttitle = {Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the {UK}},
doi = {10.1136/gut.2011.238808},
abstract = {OBJECTIVE: To determine the risk of developing complicated colonic diverticular disease (CCDD) with prior episodes of acute diverticulitis and determine the mortality of the spectrum of CCDD.
DESIGN: Population-based cohort study.
SETTING: Computerised records from the General Practice Research Database linked to Hospital Episode Statistics data from the UK.
PARTICIPANTS: Patients and controls registered in the General Practice Research Database from 1990 to 2007.
MAIN OUTCOME MEASURES: Mortality was calculated and Cox regression modelling used to provide adjusted HRs and 95\% CI. Logistic regression was used to model the effect of prior acute diverticulitis on the development of complications.
RESULTS: 2950 patients (1872 (63.5\%) female) had a diagnosis of CCDD (8739 controls). A total of 1042 (35.3\%) patients died compared with 2062 (23.6\%) controls. Most excess deaths occurred in the first year after the complication. Patients with a perforation/abscess had a 4.5-fold increase in 1-year mortality (HR 4.55, 95\% CI 3.74 to 5.52) compared with the general population, whereas those with a fistula or stricture had a 2.5-fold increase in mortality (fistula HR 2.60, 95\% CI 1.47 to 4.62; stricture HR 2.41, 95\% CI 1.86 to 3.11). Although most patients (2133 (72.3\%)) had suffered no prior episodes of acute diverticulitis, increasing episodes of acute diverticulitis were associated with an increased risk of developing a fistula (two or more prior episodes, OR 1.54 95\%, CI 1.08 to 2.19), but there was no clear relationship with stricture or perforation/abscess.
CONCLUSIONS: Although most patients have experienced no prior episodes of acute diverticulitis, fistula formation is preceded by bouts of inflammation. Excess 1-year mortality across the spectrum of CCDD compared with the general population is substantial.},
language = {eng},
number = {1},
journal = {Gut},
author = {Humes, David J. and West, Joe},
month = jan,
year = {2012},
pmid = {21551188},
keywords = {Acute Disease, Aged, Aged, 80 and over, Case-Control Studies, Cohort Studies, Constriction, Pathologic, Diverticulitis, Colonic, Female, Great Britain, Humans, Intestinal Fistula, Intestinal Obstruction, Intestinal Perforation, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Proportional Hazards Models, Risk, abscess},
pages = {95--100}
}
Downloads: 0
{"_id":"WBE4oXEwDhgRZyqkt","bibbaseid":"humes-west-roleofacutediverticulitisinthedevelopmentofcomplicatedcolonicdiverticulardiseaseand1yearmortalityafterdiagnosisintheukpopulationbasedcohortstudy-2012","downloads":0,"creationDate":"2017-08-15T09:38:11.708Z","title":"Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the UK: population-based cohort study","author_short":["Humes, D. J.","West, J."],"year":2012,"bibtype":"article","biburl":"http://bibbase.org/zotero/veegee78","bibdata":{"bibtype":"article","type":"article","title":"Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the UK: population-based cohort study","volume":"61","issn":"1468-3288","shorttitle":"Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the UK","doi":"10.1136/gut.2011.238808","abstract":"OBJECTIVE: To determine the risk of developing complicated colonic diverticular disease (CCDD) with prior episodes of acute diverticulitis and determine the mortality of the spectrum of CCDD. DESIGN: Population-based cohort study. SETTING: Computerised records from the General Practice Research Database linked to Hospital Episode Statistics data from the UK. PARTICIPANTS: Patients and controls registered in the General Practice Research Database from 1990 to 2007. MAIN OUTCOME MEASURES: Mortality was calculated and Cox regression modelling used to provide adjusted HRs and 95% CI. Logistic regression was used to model the effect of prior acute diverticulitis on the development of complications. RESULTS: 2950 patients (1872 (63.5%) female) had a diagnosis of CCDD (8739 controls). A total of 1042 (35.3%) patients died compared with 2062 (23.6%) controls. Most excess deaths occurred in the first year after the complication. Patients with a perforation/abscess had a 4.5-fold increase in 1-year mortality (HR 4.55, 95% CI 3.74 to 5.52) compared with the general population, whereas those with a fistula or stricture had a 2.5-fold increase in mortality (fistula HR 2.60, 95% CI 1.47 to 4.62; stricture HR 2.41, 95% CI 1.86 to 3.11). Although most patients (2133 (72.3%)) had suffered no prior episodes of acute diverticulitis, increasing episodes of acute diverticulitis were associated with an increased risk of developing a fistula (two or more prior episodes, OR 1.54 95%, CI 1.08 to 2.19), but there was no clear relationship with stricture or perforation/abscess. CONCLUSIONS: Although most patients have experienced no prior episodes of acute diverticulitis, fistula formation is preceded by bouts of inflammation. Excess 1-year mortality across the spectrum of CCDD compared with the general population is substantial.","language":"eng","number":"1","journal":"Gut","author":[{"propositions":[],"lastnames":["Humes"],"firstnames":["David","J."],"suffixes":[]},{"propositions":[],"lastnames":["West"],"firstnames":["Joe"],"suffixes":[]}],"month":"January","year":"2012","pmid":"21551188","keywords":"Acute Disease, Aged, Aged, 80 and over, Case-Control Studies, Cohort Studies, Constriction, Pathologic, Diverticulitis, Colonic, Female, Great Britain, Humans, Intestinal Fistula, Intestinal Obstruction, Intestinal Perforation, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Proportional Hazards Models, Risk, abscess","pages":"95--100","bibtex":"@article{humes_role_2012,\n\ttitle = {Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the {UK}: population-based cohort study},\n\tvolume = {61},\n\tissn = {1468-3288},\n\tshorttitle = {Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the {UK}},\n\tdoi = {10.1136/gut.2011.238808},\n\tabstract = {OBJECTIVE: To determine the risk of developing complicated colonic diverticular disease (CCDD) with prior episodes of acute diverticulitis and determine the mortality of the spectrum of CCDD.\nDESIGN: Population-based cohort study.\nSETTING: Computerised records from the General Practice Research Database linked to Hospital Episode Statistics data from the UK.\nPARTICIPANTS: Patients and controls registered in the General Practice Research Database from 1990 to 2007.\nMAIN OUTCOME MEASURES: Mortality was calculated and Cox regression modelling used to provide adjusted HRs and 95\\% CI. Logistic regression was used to model the effect of prior acute diverticulitis on the development of complications.\nRESULTS: 2950 patients (1872 (63.5\\%) female) had a diagnosis of CCDD (8739 controls). A total of 1042 (35.3\\%) patients died compared with 2062 (23.6\\%) controls. Most excess deaths occurred in the first year after the complication. Patients with a perforation/abscess had a 4.5-fold increase in 1-year mortality (HR 4.55, 95\\% CI 3.74 to 5.52) compared with the general population, whereas those with a fistula or stricture had a 2.5-fold increase in mortality (fistula HR 2.60, 95\\% CI 1.47 to 4.62; stricture HR 2.41, 95\\% CI 1.86 to 3.11). Although most patients (2133 (72.3\\%)) had suffered no prior episodes of acute diverticulitis, increasing episodes of acute diverticulitis were associated with an increased risk of developing a fistula (two or more prior episodes, OR 1.54 95\\%, CI 1.08 to 2.19), but there was no clear relationship with stricture or perforation/abscess.\nCONCLUSIONS: Although most patients have experienced no prior episodes of acute diverticulitis, fistula formation is preceded by bouts of inflammation. Excess 1-year mortality across the spectrum of CCDD compared with the general population is substantial.},\n\tlanguage = {eng},\n\tnumber = {1},\n\tjournal = {Gut},\n\tauthor = {Humes, David J. and West, Joe},\n\tmonth = jan,\n\tyear = {2012},\n\tpmid = {21551188},\n\tkeywords = {Acute Disease, Aged, Aged, 80 and over, Case-Control Studies, Cohort Studies, Constriction, Pathologic, Diverticulitis, Colonic, Female, Great Britain, Humans, Intestinal Fistula, Intestinal Obstruction, Intestinal Perforation, Kaplan-Meier Estimate, Logistic Models, Male, Middle Aged, Proportional Hazards Models, Risk, abscess},\n\tpages = {95--100}\n}\n\n","author_short":["Humes, D. J.","West, J."],"key":"humes_role_2012","id":"humes_role_2012","bibbaseid":"humes-west-roleofacutediverticulitisinthedevelopmentofcomplicatedcolonicdiverticulardiseaseand1yearmortalityafterdiagnosisintheukpopulationbasedcohortstudy-2012","role":"author","urls":{},"keyword":["Acute Disease","Aged","Aged","80 and over","Case-Control Studies","Cohort Studies","Constriction","Pathologic","Diverticulitis","Colonic","Female","Great Britain","Humans","Intestinal Fistula","Intestinal Obstruction","Intestinal Perforation","Kaplan-Meier Estimate","Logistic Models","Male","Middle Aged","Proportional Hazards Models","Risk","abscess"],"downloads":0},"search_terms":["role","acute","diverticulitis","development","complicated","colonic","diverticular","disease","year","mortality","diagnosis","population","based","cohort","study","humes","west"],"keywords":["acute disease","aged","aged","80 and over","case-control studies","cohort studies","constriction","pathologic","diverticulitis","colonic","female","great britain","humans","intestinal fistula","intestinal obstruction","intestinal perforation","kaplan-meier estimate","logistic models","male","middle aged","proportional hazards models","risk","abscess"],"authorIDs":[],"dataSources":["FmCWXwJibZiWNzpdc"]}