Original articleAlimentary tractLong-term Risk of Acute Diverticulitis Among Patients With Incidental Diverticulosis Found During Colonoscopy
Section snippets
Data Source
We performed a retrospective survival analysis using administrative and clinical data from the Veteran's Affairs (VA) Greater Los Angeles Healthcare System (VAGLAHS) collected between January 1996 and August 2011. VAGLAHS maintains electronic medical records from 14 community clinics and 1 inpatient academic medical center: the West Los Angeles VA. The VAGLAHS database includes patient demographics, inpatient and outpatient treatment files, and laboratory, imaging, pathology, and pharmacy data.
Patient Characteristics and Descriptive Statistics
Over the 15-year study period, we identified 2222 subjects with chart-confirmed colonic diverticulosis. Table 1 presents the patient characteristics and procedure indications stratified by diverticulitis status. The median follow-up period was 6.75 years (interquartile range, 3.75–9.66 y; maximum, 15 y; minimum, 1 mo; mean ± SD, 6.75 ± 3.6 y).
Incidence Rates of Diverticulitis
We identified 95 patients (4.3%) who developed acute diverticulitis based on any of the defined criteria as discussed earlier, whereas 23 (1%) had
Discussion
The natural history of diverticulosis is poorly understood. Published guidelines and reviews state that 10% to 25% of patients with colonic diverticulosis ultimately will develop diverticulitis over the course of their lifetime.5, 6, 23, 31, 32 However, this widely cited figure is based on data predating population-based screening colonoscopy.5 Therefore, the true denominator of individuals harboring diverticulosis was not accounted for in these calculations.
To calculate the true incidence of
Acknowledgments
This article was presented at the American Gastroenterological Association Distinguished Abstracts Plenary Session at Digestive Disease Week 2012, May 19-22, San Diego, California.
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The opinions and assertions contained herein are the sole views of the authors and are not to be construed as official or as reflecting the views of the Department of Veteran Affairs.
Conflicts of interest These authors disclose the following: Brennan Spiegel has served as an advisor for Ironwood Pharmaceuticals and has received research support from Amgen, Ironwood Pharmaceuticals, and Shire Pharmaceuticals; and Linnette Yen, Paul Hodgkins, and M. Haim Erder are employees of Shire Pharmaceuticals. The remaining authors disclose no conflicts.
Funding This study was supported by a research grant from Shire Development, LLC.