SA202 - National Trends in Admissions, Interventions and Outcomes for Young-Onset Diverticulitis from 2005-2020

Saturday, June 1, 2024

2:28 PM – 2:34 PM ET, USA

Location: Room 314-317

Abstract Podium Presenter(s)

SK

Shineui Kim, BA

Medical Student
David Geffen School of Medicine at UCLA
David Geffen School of Medicine at UCLA
Reseda, CA, United States

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

Author(s)

NC

Nam Yong Cho, BS

Medical Student
David Geffen School of Medicine at UCLA
Los Angeles, California, United States

Disclosure information not submitted.
SM

Saad Mallick, MD

Visiting Scholar
David Geffen School of Medicine at UCLA
Los Angeles, California, United States

Disclosure information not submitted.
JH

Joseph Hadaya, MD PhD

Resident
David Geffen School of Medicine at UCLA
Los Angeles, California, United States

Disclosure information not submitted.
PB

Peyman Benharash, MD

Associate Professor of Cardiothoracic Surgery
David Geffen School of Medicine at UCLA
Los Angeles, California, United States

Disclosure information not submitted.
Alexander Hawkins, MD, MPH

Associate Professor of Surgery
Vanderbilt University Medical Center
VIMC
Nashville, Tennessee, United States

All relevant financial disclosures have been managed and will be listed below.
This individual has no financial relationships with ineligible companies.
Hanjoo Lee, MD, MS, FACS

Assistant Professor of Surgery
Division of Colon and Rectal Surgery, Harbor-UCLA Medical Center, Torrance, CA
UCLA School of Medicine
Torrance, California, United States

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

Senior Author(s)

Aimal Khan, MD, FACS

Assistant Professor
Vanderbilt University Medical Center
Vanderbilt University Medical Center
NASHVILLE, TN, United States

Disclosure information not submitted.

Purpose/Background: Little is known about the burden and outcomes of diverticulitis in patients under the age of 50. In this study, we analyzed national trends in hospitalizations, surgical and non-surgical interventions, and outcomes for young-onset diverticulitis.

Methods/Interventions: The 2005-2020 National Inpatient Sample was queried to identify all adults (≥ 18 years) hospitalized for diverticulitis. Patient diagnoses, procedures and characteristics were identified using the International Classification of Diseases. Complicated diverticulitis was defined as hospitalizations with abscesses, perforations, or gastrointestinal bleeding. Patients under the age of 50 were categorized as Young cohort (others: Adult). The primary outcome of interest was national trends in the incidence of young-onset diverticulitis related admissions. Secondary outcomes included trends in the need for interventional radiology (IR), colectomy, mortality, major complications, duration of hospitalization, and costs. Cuzick’s non-parametric rank-based test (nptrend) was used to ascertain the significance of temporal trends. Entropy balancing was used to account for intergroup differences. A doubly robust multivariable regression was used to examine the outcomes of interest.

Results/Outcomes: Of 5,655,003 patients hospitalized for diverticulitis, 906,229 (16.0%) were considered young-onset diverticulitis. The Young cohorts’ median age was 42 years while the Adult cohorts’ was 72 years old (42 [37-46] vs 72 [62-82], P< 0.001). Young cohorts were less commonly female (40.7 vs 59.7, P< 0.001) and had a lower burden of comorbidities (Elixhauser Comorbidity Index 1 [0-2] vs. 3 [2-4], P< 0.001).
During the study period, the proportion of Young cohort admitted for complicated-diverticulitis significantly increased from 13.2% to 32.2% (nptrend < 0.001; Figure A) Additionally, there has been a decline in the proportion of young-onset diverticulitis patients needing a colectomy (36.5% to 19.5%, nptrend < 0.001), with a corresponding increase in the proportion of patients needing IR intervention (13.5% to 24.8%, nptrend < 0.001; Figure B).
Compared to adult-onset diverticulitis, young-onset diverticulitis was associated with decreased odds of mortality (Adjusted Odds Ratio [AOR] 0.18, 95% Confidence Interval (95%CI) 0.16-0.20, P< 0.001) as well as decreased length of stay (β -0.13 days, 95% CI [-0.16,-0.11], P< 0.001) and hospitalization costs (β -$500, 95%CI [-$600,-$400], P< 0.001). Additionally, young-onset diverticulitis was also associated with increased odds of colectomy (AOR 1.29, 95%CI 1.27-1.63, P< 0.001) and IR drainage (AOR 1.58, 95%CI 1.53-1.63, P< 0.001).

Conclusion/Discussion: There has been a significant increase in the incidence of complicated-diverticulitis related admissions among patients under 50. Future work is needed to determine the cause for these trends and identify public health policies aimed at potential prevention of such more virulent form of diverticulitis among the younger population.