Risk factors for emergency surgery for diverticulitis: A retrospective multicentric French study at 41 hospitals.
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Godet Camille, Sabbagh Charles, Beyer-Berjot Laura, Ouaissi Mehdi, Zerbib Philippe, Valérie Bridoux, Manceau Gilles, Panis Yves, Buscail Etienne, Venara Aurélien, Khaoudy Iman, Gaillard Martin, Viennet Manon, Thobie Alexandre, Menahem Benjamin, Eveno Clarisse, Bonnel Catherine, Mabrut Jean-Yves, Badic Bogdan, Chautard Julien, Eid Yassine, Duchalais Emilie, Lakkis Zaher, Cotte Eddy, Laforest Anaïs, Desfourneaux-Denis Véronique, Maggiori Léon, Rebibo Lionel, Niki Christou, Talal Ali, Mege Diane, Bonnamy Cécile, Germain Adeline, Mauvais François, Tresallet Christophe, Roudie Jean, Laurent Alexis, Trilling Bertrand, Bertrand Martin, Massalou Damien, Romain Benoit, Tranchart Hadrien, Pellegrin Alexandra, Dejardin Olivier, Alves Arnaud, French Surgical Association∗
Аннотация
METHOD: The primary outcomes were the rate of emergency surgery for sigmoid diverticulitis and its associated risk factors. The urgent or elective nature of the surgical intervention was provided by the surgeon and in accordance with the indication for surgical treatment. A mixed logistic regression with a random intercept after multiple imputations by the chained equation was performed to consider the influence of missing data on the results.
RESULTS: Between 2010 and 2021, 6,867 patients underwent surgery for sigmoid diverticulitis in the participating centers, of which one-third (n = 2317) were emergency cases. In multivariate regression analysis with multiple imputation by chained equation, increasing age, body mass index <18.5 kg/m2, neurologic and pulmonary comorbidities, use of anticoagulant drugs, immunocompromised status, and first attack of sigmoid diverticulitis were independent risk factors for emergency surgery. The likelihood of emergency surgery was significantly more frequent after national guidelines, which were implemented in 2017, only in patients with a history of sigmoid diverticulitis attacks.
CONCLUSION: The present study highlights a high rate (33%) of emergency surgery for sigmoid diverticulitis in France, which was significantly associated with patient features and the first attack of diverticulitis.