Characteristics and Treatment Outcomes of Colonic Diverticulitis in Hospitalized Patients in Thailand
Siam Sirinthornpunya MD*
Affiliation : * Department of Medicine, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
Background : Colonic diverticular disease exhibits mucosal outpouchings through the large intestine. Common complications
of this disease are diverticular bleeding and diverticulitis. The prevalence of the disease is age-dependent, and some patients
with diverticulitis develop complications especially the elderly, the obese and those with co-morbid diseases. In a retrospective
study in Chiang Mai, Thailand, the mortality rate was 3.6% at 30 days and 9.2% at 1 year.
Objective : To determine the financial burden, clinical characteristics and factors associated with severity and mortality of
patients with colonic diverticulitis.
Material and Method: This was a retrospective study of in-patients from hospitals nationwide, and data were retrieved from
three major health care system databases in the fiscal year 2010, searching for ICD code 10. Patients diagnosed with
diverticular disease of the large intestine were included in this study, and baseline characteristics and clinical outcomes were
analyzed. The study was approved by the institutional ethics committee of Rajavithi Hospital.
Results : One thousand seven hundred and fifty patients with colonic diverticulitis were enrolled in the study and their data
were analyzed. The mean age of the patients was 61.15+16.12 years old, about 70% of patients had co-morbid diseases, and
the incidence of complicated colonic diverticulitis was 14.51%. The median length of hospital stay (LOS) was 6 days, half of
the patients underwent surgery, and the mortality rate was 3.26%. Multivariate regression analysis revealed that the
parameters associated with disease severity were number of co-morbid diseases, the universal coverage health care system,
and surgical treatment, while the parameters associated with mortality were having more than two co-morbid diseases and
being in the universal coverage health care system.
Conclusion : Colonic diverticulitis was common in elderly patients and associated with co-morbid diseases. Most patients
had mild severity but a high rate of surgery, and the mortality rate was higher than in western countries. Parameters
associated with disease severity and mortality were having co-morbid disease, being in the universal coverage healthcare
system and having surgical treatment.
Keywords : Colonic diverticulitis, Treatment outcome, Mortality rate, Length of stay (LOS)
