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The Trends of Complicated Acute Colonic Diverticulitis—A Systematic Review of the National Administrative Databases

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Department of General Surgery and Surgical Oncology, Hospital of Terni, University of Perugia, 05100 Terni, Italy
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Department of Surgery, Military Medical Academy, ul. “Sv. Georgi Sofiyski” 3, 1606 Sofia, Bulgaria
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Chirurgia Generale, Ospedale della Media Valle del Tevere, via del Buda, 06059 Todi, Italy
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Unit of Coloproctology, Department of Surgery, Borea Hospital, 18038 Sanremo, Italy
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Department of Molecular and Translational Medicine, University of Brescia, 25121 Brescia, Italy
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Gastroenterology and Digestive Endoscopy Unit, Sant’Anna e San Sebastiano Hospital, 81100 Caserta, Italy
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Department of Medical Surgery, Sciences and Translational Medicine University Sapienza, 00189 Rome, Italy
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Department of Gastroenterology and Hepatology, Military Medical Academy, ul. “Sv. Georgi Sofiiski“ 3, 1606 Sofia, Bulgaria
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Colorectal Surgery, BioMedical Institute, 16157 Genova, Italy
*
Author to whom correspondence should be addressed.
Medicina 2019, 55(11), 744; https://doi.org/10.3390/medicina55110744
Received: 3 September 2019 / Revised: 28 October 2019 / Accepted: 12 November 2019 / Published: 16 November 2019
(This article belongs to the Section Emergency Medicine)
Background and Objectives: The diverticular disease includes a broad spectrum of different “clinical situations” from diverticulosis to acute diverticulitis (AD), with a full spectrum of severity ranging from self-limiting infection to abscess or fistula formation to free perforation. The present work aimed to assess the burden of complicated diverticulitis through a comparative analysis of the hospitalizations based on the national administrative databases. Materials and Methods: A review of the international and national administrative databases concerning admissions for complicated AD was performed. Results: Ten studies met the inclusion criteria and were included in the analysis. No definition of acute complicated diverticulitis was reported in any study. Complicated AD accounted for approximately 42% and 79% of the hospitalizations. The reported rates of abscess varied between 1% and 10% from all admissions for AD and 5–29% of the cases with complicated AD. An increasing temporal trend was found in one study–from 6% to 10%. The rates of diffuse peritonitis ranged from 1.6% to 10.2% of all hospitalizations and 11% and 47% of the complicated cases and were stable in the time. Conclusions: The available data precluded definitive conclusions because of the significant discrepancy between the included studies. The leading cause was the presence of heterogeneity due to coding inaccuracies in all databases, absence of ICD codes to distinguish the different type of complications, and the lack of coding data about some general conditions such as sepsis, shock, malnutrition, steroid therapy, diabetes, pulmonary, and heart failure. View Full-Text
Keywords: complicated acute colonic diverticulitis; temporal trends; hospitalization; national databases complicated acute colonic diverticulitis; temporal trends; hospitalization; national databases
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Cirocchi, R.; Popivanov, G.; Corsi, A.; Amato, A.; Nascimbeni, R.; Cuomo, R.; Annibale, B.; Konaktchieva, M.; Binda, G.A. The Trends of Complicated Acute Colonic Diverticulitis—A Systematic Review of the National Administrative Databases. Medicina 2019, 55, 744.

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