TY - JOUR
T1 - Cirrhosis Is Associated with Increased Mortality in Patients with Diverticulitis
T2 - A Nationwide Cross-Sectional Study
AU - Kruger, Andrew J.
AU - Mumtaz, Khalid
AU - Anaizi, Ahmad
AU - Modi, Rohan M.
AU - Hussan, Hisham
AU - Zhang, Cheng
AU - Hinton, Alice
AU - Conwell, Darwin L.
AU - Krishna, Somashekar G.
AU - Stanich, Peter P.
N1 - Publisher Copyright:
© 2017, Springer Science+Business Media, LLC.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Background: Diverticulitis in patients with cirrhosis has been associated with higher surgical mortality, but no prior studies evaluate non-surgical treatment results. Aims: Our aim was to compare the outcomes of hospitalization for diverticulitis in patients with and without cirrhosis. Methods: We utilized the Nationwide Inpatient Sample (2007–2013) for patients with and without cirrhosis hospitalized for diverticulitis. Patients were further stratified by the presence of compensated versus decompensated cirrhosis. Validated ICD-9 codes captured patients and surgical procedures. Multivariate logistic regression models were fit. The primary outcomes of interest were mortality and surgical intervention rates. Results: There were 1,555,469 patients hospitalized for diverticulitis without cirrhosis, and 7523 patients hospitalized for diverticulitis with cirrhosis. On multivariate analysis, patients with cirrhosis had an increased mortality rate (OR 2.28; 95% CI 1.48–3.5). There were no significant differences in surgical interventions. Subgroup multivariate analyses of compensated cirrhosis (n = 6170) and decompensated cirrhosis (n = 1353) revealed that decompensated cirrhosis had an increased mortality rate (OR 4.99; 95% CI 2.48–10.03) when compared to patients without cirrhosis, whereas those with compensated cirrhosis did not (OR 1.67; 95% CI 0.96–2.91). Those with compensated cirrhosis underwent less surgical interventions (OR 0.82; 95% CI 0.67–0.99) compared to those without cirrhosis. Patients with diverticulitis and cirrhosis had increased costs and lengths of hospitalization. Conclusion: Presence of cirrhosis in patients hospitalized for diverticulitis is associated with an increased mortality rate. These are novel findings, and future clinical studies should focus on improving diverticulitis outcomes in this group.
AB - Background: Diverticulitis in patients with cirrhosis has been associated with higher surgical mortality, but no prior studies evaluate non-surgical treatment results. Aims: Our aim was to compare the outcomes of hospitalization for diverticulitis in patients with and without cirrhosis. Methods: We utilized the Nationwide Inpatient Sample (2007–2013) for patients with and without cirrhosis hospitalized for diverticulitis. Patients were further stratified by the presence of compensated versus decompensated cirrhosis. Validated ICD-9 codes captured patients and surgical procedures. Multivariate logistic regression models were fit. The primary outcomes of interest were mortality and surgical intervention rates. Results: There were 1,555,469 patients hospitalized for diverticulitis without cirrhosis, and 7523 patients hospitalized for diverticulitis with cirrhosis. On multivariate analysis, patients with cirrhosis had an increased mortality rate (OR 2.28; 95% CI 1.48–3.5). There were no significant differences in surgical interventions. Subgroup multivariate analyses of compensated cirrhosis (n = 6170) and decompensated cirrhosis (n = 1353) revealed that decompensated cirrhosis had an increased mortality rate (OR 4.99; 95% CI 2.48–10.03) when compared to patients without cirrhosis, whereas those with compensated cirrhosis did not (OR 1.67; 95% CI 0.96–2.91). Those with compensated cirrhosis underwent less surgical interventions (OR 0.82; 95% CI 0.67–0.99) compared to those without cirrhosis. Patients with diverticulitis and cirrhosis had increased costs and lengths of hospitalization. Conclusion: Presence of cirrhosis in patients hospitalized for diverticulitis is associated with an increased mortality rate. These are novel findings, and future clinical studies should focus on improving diverticulitis outcomes in this group.
KW - Colon
KW - Liver
KW - Outcomes
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85030711189&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85030711189&partnerID=8YFLogxK
U2 - 10.1007/s10620-017-4782-9
DO - 10.1007/s10620-017-4782-9
M3 - Article
C2 - 28986716
AN - SCOPUS:85030711189
SN - 0163-2116
VL - 62
SP - 3149
EP - 3155
JO - Digestive Diseases and Sciences
JF - Digestive Diseases and Sciences
IS - 11
ER -