Gregersen R, et al. - An inquiry was carried out of the long-term mortality, recurrence, and death associated with recurrence for subjects admitted with acute diverticulitis with abscess formation (Hinchey stage Ib-II). Data demonstrated a high mortality and recurrence rate following diverticular abscesses. Comparable survival was brought to light between treatment groups. However, patients treated with drainage displayed a substantially higher risk of recurrence.

Methods

• Candidates were selected by linking administrative registers for all Danish citizens in years 2000-2012.
• The identification was undertaken from ICD-10 discharge codes, with stratification based on treatment (antibiotics, percutaneous abscess drainage, or surgery).

Results

• Out of 6,641,672 individuals, researchers selected 3,148 patients with acute diverticulitis with abscess formation.
• Findings unveiled comparable survival among treatment groups with a 1-year survival of 81-83% and a 5-year survival of 66-67% (p=0.66).
• Before admission, the use of glucocorticoid raised the risk of mortality with hazard ratio 1.64 (95%CI 1.39-1.93), 1.77 (1.20-2.63), and 1.92 (1.07-3.44) for the antibiotics, drainage, and operative treatment group, respectively.
• An increase was noted in the risk of recurrence due to drainage treatment with sub-distribution hazard (SDH) of 1.52 (1.19-1.95).
• Moreover, operative treatment led to a decrease in the risk with a SDH of 0.55 (0.32-0.93), both compared with antibiotic treatment (p=0.0001).
• The presence of recurrence was discovered in 23.6% (18.5-30.1%) of subjects in the drainage group, 15.5% (13.9-17.3%) in the antibiotics group, and 9.1% (5.1-16.1%) in the operative group.
• It was determined that the recurrence-related mortality was 2.0% (0.9-4.4%) for the drainage group, 1.1% (0.7-1.8%) for the antibiotics group, and 0.6% (0.1-4.3%) for the operative group (p=0.24).
• The occurrence of maximum recurrences and recurrence-related mortality was illustrated within the first year after primary admission.