D0087 - Incidence of Follow-Up Colonoscopy After Acute Diverticulitis: A Single-Center Experience

Rahul Karna, MD¹, Bandhul Hans, MD², Usman Tariq, MD¹, Shifa Umar, MD³, Nabeeha Mohy-Ud-Din, MD¹, Suzanne Morrissey, MD^2
1Allegheny Health Network, Pittsburgh, PA; ²Allegheny General Hospital, Pittsburgh, PA; ³Mayo Clinic, Rochester, MN

Introduction: Acute diverticulitis (AD) is the third most common inpatient gastrointestinal (GI) diagnosis in the United States. Guidelines recommend a follow-up colonoscopy in complicated diverticulitis and after first episode of uncomplicated AD to rule out underlying adenoma and colorectal cancer. We conducted a retrospective study to assess our institution’s adherence to guidelines by determining the incidence of follow-up colonoscopies in patients with AD.

Methods: We conducted a retrospective chart review of all adult patients presenting to Allegheny Health Network with AD. Demographic details, imaging, treatment, discharge, and follow-up data were collected. Chi-square test or Fisher’s exact test were used for categorical variables. P-value < 0.05 was considered statistically significant.

Results: We included 489 patients with age 64.06±14.82 years, comprising 222/489 (45.03%) males in our study. Left-sided diverticulitis was most common 459/489 (93.9%), followed by right sided 20/489 (4.1%) and bilateral 6/489 (1.2%). 272/485 (56.1%) had complicated diverticulitis. Only 53/272 (19.5%) patients with complicated AD and 63/213 (29.6%) patients with uncomplicated AD received colonoscopy referrals at discharge. Among inpatient teams, teaching teams had higher referral rates for follow up colonoscopy (18/38, 47.4%) as compared to private (52/253, 20.6%) and surgery (34/166, 20.5%) teams (p-value:0.001). Follow-up colonoscopy was done in 82/213 (38.5%) and 109/272 (51.1%) in uncomplicated and complicated diverticulitis respectively. Colonoscopy was performed in 50/213 (23.5%) and 73/272 (26.8%) in uncomplicated and complicated diverticulitis groups respectively for screening of colorectal cancer after the episode of diverticulitis. Further analysis showed that odds of GI follow-up were 3.6 times greater for patients with a PCP follow-up than without a PCP follow-up (95% CI:1.93-6.59). Patients were 1.7 times more likely to have a colonoscopy follow-up if they had a PCP follow-up (95% CI:1.18-2.50).

Discussion: Our study shows low adherence to guidelines for follow-up colonoscopy after the episode of acute diverticulitis especially among private hospitalists and surgical teams. Patients should get PCP to follow up on discharge to improve adherence to follow-up GI visits and colonoscopy. This allows for the opportunity to further educate medicine providers, which can improve early diagnostic rates of adenoma and colorectal carcinoma in this population.


Disclosures:


Rahul Karna, MD¹, Bandhul Hans, MD², Usman Tariq, MD¹, Shifa Umar, MD³, Nabeeha Mohy-Ud-Din, MD¹, Suzanne Morrissey, MD². D0087 - Incidence of Follow-Up Colonoscopy After Acute Diverticulitis: A Single-Center Experience, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.