eP524 - Diverticulitis, the Gift That Keeps on Giving: Long-term Quality of Life for Diverticulitis Patients After 20 Years

Monday, June 3, 2024

8:27 AM – 8:32 AM ET, USA

Location: Baltimore Convention Center, Room 318-320

Author(s)

Gabrielle E. Dombek, MD

CRS Fellow
Lahey Hospital and Medical Center
Lahey
Melrose, Massachusetts, United States

All relevant financial disclosures have been managed and will be listed below.
This individual has no financial relationships with ineligible companies.

ePoster Presenter(s)

Sarah N. Anwar, BS

Medical Student
Lahey Hospital & Medical Center, Tufts University School of Medicine
Cambridge, MA, United States

Disclosure information not submitted.

Author(s)

CH

Caroline Hayes, n/a

Medical Student
Beth Israel Lahey Hospital, Tufts University School of Medicine
Boston, Massachusetts, United States

Disclosure information not submitted.
Maggie J. McMahon, BA, MS (she/her/hers)

Medical Student
Tufts University School of Medicine
Lahey Hospital and Medical Center
Boston, MA, United States

All of the relevant financial relationships listed below have been mitigated.
This individual has no financial relationships with ineligible companies.
CM

Cody Munroe, BS, MS

Clinical Research Coordinator
Lahey Hospital
Windham, New Hampshire, United States

Disclosure information not submitted.
Jonathan Abelson, MD MS (he/him/his)

Staff Surgeon
Lahey Hospital and Medical Center
Tufts Medical Center
ARLINGTON, Massachusetts, United States

All relevant financial disclosures have been managed and will be listed below.
This individual has no financial relationships with ineligible companies.
Jason F. Hall, MD MPH FACS FASCRS

Chairman, Department of Surgery
Tufts Medical Center
Tufts Medical Center/Tufts University School of Medicine
Lincoln, Massachusetts, United States

All relevant financial disclosures have been managed and will be listed below.
This individual has no financial relationships with ineligible companies.
David A. Kleiman, MD, MSc, FACS, FASCRS

Staff Surgeon
Lahey Hospital & Medical Center
Melrose, MA, United States

Disclosure information not submitted.
AK

Angela H. Kuhnen, MD, MPH, FACS, FASCRS (she/her/hers)

Fellowship Program Director, Staff surgeon
Lahey Clinic
Tufts University School of Medicine
Burlington, Massachusetts, United States

Disclosure information not submitted.
Peter W. Marcello, MD, FACS, FASCRS (he/him/his)

Chair, Division of Colon & Rectal Surgery
Lahey Hospital & Medical Center
Burlington, Massachusetts, United States

Disclosure information not submitted.

Senior Author(s)

JS

Julia T. Saraidaridis, MD, MMSc

Staff Colon and Rectal Surgeon
Lahey Hospital
Newton, Massachusetts, United States

Disclosure information not submitted.

Purpose/Background: Current practice guidelines for the management of diverticulitis feature health-related quality of life (QoL) as one of the driving factors in making a decision to undergo surgery. Survey tools such as the diverticulitis quality of life (DV-QOL) and low anterior resection syndrome (LARS) instruments have been validated for the assessment of diverticular disease burden and the functional sequelae following lower gastrointestinal surgery. The DV-QOL considers four categories of patient experience: physical symptoms, behaviors, cognitions, and external impact of disease, with a score > 3.2 indicating high disease burden. The LARS-Q instrument identifies major and minor LARS (0-20 no LARS, 21-29 Minor LARS, 30-42 Major LARS). The aim of this study was to determine if patients who experience acute diverticulitis have lower quality of life and higher psychosocial burden from their disease at 15-20 year follow-up.Methods/Interventions: This was a retrospective case series of consecutive patients who presented to a single institution with diverticulitis from 2002 to 2008. Patients were identified with International Classification of Diseases, 9th Revision and Current Procedural Terminology codes. From June 2022 to March 2023 these patients were contacted by telephone to administer a questionnaire regarding recurrence of diverticulitis, DV-QOL and LARS instruments. Clinical variables were coded based upon chart review. Descriptive statistics were performed. Students t test and chi square test were performed to compare groups.Results/Outcomes: 954 patients were identified, of whom 624 (65.4%) were alive at the time of follow up and 128 completed the survey, yielding a response rate of 20.5%. Among these, 86 (67.2%) had at least one recurrence of diverticulitis, 29 (22.7%) had 4 or more recurrent episodes, 6 (4.7%) required an IR drainage procedure, 52 (40.6%) ultimately underwent surgery for diverticulitis, and 5 (3.9%) required emergency surgery. Median follow up was 18.5 years (IQR 17.4-19.7). Median DV-QOL score for the entire study population was 3 (IQR 0-6) and LARS score was 13 (IQR 0-24.5). There was no difference in DV-QOL score between those who underwent surgery and those who did not. Patients who did not undergo surgery had a mean LARS score of 13.8, whereas those who did undergo surgery had a LARS score was 16.5; however, this difference did not reach statistical significance [p=0.22]. Among patients who did not undergo surgery (n=76), there was a difference in mean DV-QOL score between those who experienced recurrent diverticulitis (6.37) versus those who did not have recurrence (2.76)[p=0.02]. In addition, 26.7% of patients who had recurrence described themselves as “very worried” about diverticulitis versus 9.7% without recurrence; however, this did not reach statistical significance [p=0.07].Conclusion/

Discussion: Patients with recurrent diverticulitis had higher DV-QOL scores on long-term follow-up, thereby supporting the applicability of the DV-QOL instrument even decades after index presentation.