B0101 - Octogenarians Admitted with Acute Diverticulitis Do Not Have Increased Mortality or Worse Outcomes: A Nationwide Analysis

Monday, October 24, 2022

10:00 AM – 12:00 PM ET

Location: Crown Ballroom

Presenting Author(s)

Pedro J. Palacios, MD

Mayo Clinic Florida
Jacksonville, FL

Pedro J. Palacios Argueta, MD¹, Frank Lukens, MD², Maoyin Pang, MD, PhD¹
¹Mayo Clinic Florida, Jacksonville, FL; ²Mayo Clinic Jacksonville, Jacksonville, FL

Introduction: Diverticulosis is present in around 65% of people at the age of 80. 10-25% of patients with diverticulosis will develop acute diverticulitis (AD). There is lack of data regarding outcomes in patients above the age of 80.

Methods: Retrospective cohort study of the 2018 National Inpatient Sample (NIS) using ICD10-CM/PCS codes to identify patients discharged after being admitted for AD. Patients were divided in those 80 years of age or older and those 79 years of age and younger. Primary outcomes were mortality, need for colonoscopy, total colectomy (TC), partial colectomy (PC), percutaneous drainage (PD). Secondary outcomes were length of stay (LOS), costs and charges. Multivariate regression analysis adjusted for patient and hospital characteristics was performed for the primary and secondary outcomes.

Results: A total of 214,594 discharges for AD were identified. 11.3% (n=24,169) were 80 years of age or older. Octogenarian patients were more likely to be female (74.3% vs. 55.6%, P< 0.01), Caucasian (83.2 vs. 74.3%, P< 0.01), to have uncomplicated AD (73.2% vs. 54.4%, P< 0.01), to have a Charlson Comorbidity Index score ≥3 (CCI) (30.9% vs. 10.1%, P< 0.01), to have Medicare as primary payer (95.9% vs. 37.5%, P< 0.01), to have malnutrition (8.7% vs. 3.5%, P< 0.01) and require parenteral nutrition(1.7% vs. 1.3%, P=.02). They are less likely to have obesity (7.0% vs. 21.6%, P< 0.01), alcohol use disorder (0.4% vs. 2.5%, P< 0.01), cannabis use disorder (0.1% vs. 1.7%, P< 0.01), Elderly patients had lower rates of TC (6.8%% vs. 17.2%, P< 0.01), PC (4.3% vs. 10.1%, P< 0.01). They had higher mean LOS (5.1 vs. 4.4 days p< 0.01). On multivariate analysis octogenarians did not have increased odds of mortality (aOR 0.80, 95% CI [0.45-1.39]) or PD (aOR 0.90, 95% CI [0.39-2.09]). Octogenarians had lower significant odds of colonoscopy (aOR 0.72, 95% CI [0.87-1.77], TC (aOR 0.38, 95% CI [0.33-0.43]), PC (aOR 0.48, 95% CI 0.41-0.56]). There was no difference in total costs ($-191, 95% CI [-690-307]) and charges ($-1,156, 95% CI [-3,402-1,089]).

Discussion: In this study 11.3% of patients admitted with AD were 80 years of age or older. Octogenarians do not have higher risk of mortality, surgical intervention or healthcare expenditure, likely related to a less complicated disease presentation in this set of patients.

Table 1. Univariate and multivariate analysis for primary and secondary outcomes
	Colonoscopy / flexible sigmoidoscopy	Total Colectomy	Partial colectomy	Percutaneous drainage of abscess
	Crude Odds Ratio (95% Confidence interval)
Age ≥ 80	0.92 (0.82-1.05)	0.74 (0.70-0.78)	0.40 (0.35-0.46)	0.77 (0.40-1.48)
	Adjusted Odds Ratio; (95% Confidence interval)
Age ≥ 80	0.72 (0.62-0.83)	0.38 (0.33-0.43)	0.48 (0.41-0.56)	0.90 (0.39- 2.09)

	Mortality	Length of stay (Days)	Total Costs (US$)	Total Charges (US$)
	Crude Odds Ratio (95% Confidence interval)
Age ≥ 80	5.36 (3.89-7.38)	0.69 (0.56-0.82)	-153 (-653-347)	626 (-1,703-2,956)
	Adjusted Odds Ratio; (95% Confidence interval)
Age ≥ 80	0.80 (0.45-1.39)	0.12 (-0.02-0.26)	-191 (-690-307)	-1,156 (-3,402-1,089)

Table: Univariate and multivariate analysis for primary and secondary outcomes

Disclosures:

Pedro Palacios Argueta indicated no relevant financial relationships.

Frank Lukens indicated no relevant financial relationships.

Maoyin Pang indicated no relevant financial relationships.

Pedro J. Palacios Argueta, MD¹, Frank Lukens, MD², Maoyin Pang, MD, PhD¹. B0101 - Octogenarians Admitted with Acute Diverticulitis Do Not Have Increased Mortality or Worse Outcomes: A Nationwide Analysis, ACG 2022 Annual Scientific Meeting Abstracts. Charlotte, NC: American College of Gastroenterology.