P0143 - Predictors of In-Hospital Mortality in Acute Colonic Diverticulitis

Sunday, October 24, 2021

3:30 PM – 7:00 PM PT

Location: Shoreline Exhibit Hall

Has Audio

Presenting Author(s)

Ammar Ahmad, MD

Wright State University Boonshoft School of Medicine
TIPP CITY, OH, United States

Ammar Ahmad, MD, Ronald Markert, PhD, David Mossad, MD, Padmini Krishnamurthy, MD
Wright State University Boonshoft School of Medicine, Dayton, OH

Introduction: Acute colonic diverticulitis is an increasingly common acute abdominal condition in the western world. Most patients have uncomplicated acute diverticulitis, while some develop serious complications such as colonic perforation, abscess formation, intestinal obstruction, and formation of fistula between the colon and adjacent viscera. The purpose of this study was to evaluate demographics, comorbidity burden, hospital characteristics, length of stay (LOS), and principal payment method and their effect on in-hospital mortality in patients admitted for acute colonic diverticulitis.

Methods: Data were collected from The National Hospital Discharge Survey (NHDS) for patients admitted for acute colonic diverticulitis between 2001 and 2010. Two groups: patients discharged alive vs. those who died in the hospital were compared on demographics, LOS, comorbidity burden, principal payment, hospital location, hospital size, and type of admission. SPSS was used for chi-square testing and the Mann-Whitney test at alpha of 0.05. Multivariable logistic regression identified independent predictors of mortality.

Results: Acute colonic diverticulitis was identified in 18,999 patients, 212 (1.1%) of whom suffered in-hospital mortality. Patients who died in the hospital were significantly older and had a longer LOS. Female patients were more likely to die in the hospital compared to male patients. The mean number of comorbidities was greater in patients who died in the hospital. Emergent/Urgent vs. elective admission was associated with in-hospital mortality. Region, hospital size, and ownership of hospital did not differ in mortality (Table 1). Additionally, multivariable logistic regression showed age, female sex, LOS, number of comorbidities, and emergent/urgent admission to be independent predictors of mortality after controlling for the other four predictors.

Discussion: Acute colonic diverticulitis is a common acute abdominal condition that can lead to serious complications including death. We found that age, sex, LOS, number of comorbidities, and type of admission have an independent impact on in-hospital mortality. The strength of our study lies in the large sample size, whereas the major limitation of our study is that clinical characteristics could not be examined as NHDS data did not include lab values, treatment choices, or follow-up information.

		Alive	Deceased	p
No. of Patients		18787 (98.9%)	212 (1.1%)
Age (Mean ± SD)		61.7 ± 16.2	79.4 ± 10.8	< 0.001
Sex	Male	7697 (99.1%)	73 (0.9%)	0.05
Sex	Female	11090 (98.8%)	139 (1.2%)	0.05
Race	Caucasian	11507 (98.8%)	135 (1.2%)	0.6
	African American	1431 (98.8%)	17 (1.2%)
	American Indian	33 (97.1%)	1 (2.9%)
	Asian	69 (100%)	0 (0%)
	Native Hawaiian	8 100%)	0 (0%)
	Other	458 (99.3%)	3 (0.7%)
	Multiple Races	5 (100%)	0 (0%)
	Not Stated	5276 (98.9%)	56 (1.1%)
Length of Stay (Mean ± SD)		5.44 ± 5.38	12.25 ± 15.08	< 0.001
Number of Comorbidities (Mean ± SD)		4.29 ± 2.28	6.15 ± 1.94	< 0.001
Region	Northeast	4677 (98.9%)	54 (1.1%)	0.51
	Midwest	5904 (98.8%)	72 (1.2%)
	South	6417 (98.9%)	72 (1.1%)
	West	1789 (99.2%)	14 (0.8%)
Number of Beds in Hospital	6 to 99	3242 (98.7%)	43 (1.3%)	0.65
	100 to 199	4484 (98.9%)	52 (1.1%)
	200 to 299	4302 (98.9%)	50 (1.1%)
	300 to 499	4797 (99.1%)	46 (0.9%)
	> 500	1962 (98.9%)	21 (1.1%)
Hospital Ownership	Proprietary	1775 (98.7%)	24 (1.3%)	0.34
	Government	1281 (99.2%)	10 (0.8%)
	Non-profit	15731 (98.9%)	178 (1.1%)
Principal Payment	Worker's Compensation	8 (100%)	0 (0%)	< 0.001
	Medicare	8098 (97.8%)	178 (2.2%)
	Medicaid	817 (99.6%)	3 (0.4%)
	Other Government	172 (100%)	0 (0%)
	Blue Cross/Blue Shield	2626 (99.7%)	7 (0.3%)
	HMO/PPO	3658 (99.7%)	11 (0.3%)
	Other Private Insurance	2053(99.6%)	9 (0.4%)
	Self-Pay	740 99.9%)	1 (0.1%)
	No Charge	57 (100%)	0 (0%)
	Other	342 (99.4%)	2 (0.6%)
	Not Stated	225 (99.6%)	1 (0.4%)
Type of Admission	Emergency	10376 (98.7%)	132 (1.3%)	< 0.001
	Urgent	3286 (98.9%)	38 (1.1%)
	Elective	3584 (99.5%)	17 (0.5%)
	Not Available	1541 (98.4%)	25 (1.6%)

Table: Table 1: Characteristics of patients with acute colonic diverticulitis

Disclosures:

Ammar Ahmad indicated no relevant financial relationships.

Ronald Markert indicated no relevant financial relationships.

David Mossad indicated no relevant financial relationships.

Padmini Krishnamurthy indicated no relevant financial relationships.

Ammar Ahmad, MD, Ronald Markert, PhD, David Mossad, MD, Padmini Krishnamurthy, MD. P0143 - Predictors of In-Hospital Mortality in Acute Colonic Diverticulitis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.