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憩室疾病的住院人数正在增加,老年人和急症入院患者的预后较差。

Diverticular disease hospital admissions are increasing, with poor outcomes in the elderly and emergency admissions.

机构信息

Department of Colorectal Surgery, King's College Hospital, London, UK.

出版信息

Aliment Pharmacol Ther. 2009 Dec 1;30(11-12):1171-82. doi: 10.1111/j.1365-2036.2009.04098.x. Epub 2009 Jul 20.

DOI:10.1111/j.1365-2036.2009.04098.x
PMID:19681811
Abstract

BACKGROUND

Diverticular disease has a changing disease pattern with limited epidemiological data.

AIM

To describe diverticular disease admission rates and associated outcomes through national population study.

METHODS

Data were obtained from the English 'Hospital Episode Statistics' database between 1996 and 2006. Primary outcomes examined were 30-day overall and 1-year mortality, 28-day readmission rates and extended length of stay (LOS) beyond the 75th percentile (median inpatient LOS = 6 days). Multiple logistic regression analysis was used to determine independent predictors of these outcomes.

RESULTS

Between the study dates 560 281 admissions with a primary diagnosis of diverticular disease were recorded in England. The national admission rate increased from 0.56 to 1.20 per 1000 population/year. 232 047 (41.4%) were inpatient admissions and, of these, 55 519 (23.9%) were elective and 176 528 (76.1%) emergency. Surgery was undertaken in 37 767 (16.3%). The 30-day mortality was 5.1% (n = 6735) and 1-year mortality was 14.5% (n = 11 567). The 28-day readmission rate was 9.6% (n = 21 160). Increasing age, comorbidity and emergency admission were independent predictors of all primary outcomes.

CONCLUSIONS

Diverticular disease admissions increased over the course of the study. Patients of increasing age, admitted as emergency and significant comorbidity should be identified, allowing management modification to optimize outcomes.

摘要

背景

憩室疾病的发病模式在不断变化,相关流行病学数据有限。

目的

通过全国人群研究描述憩室疾病的入院率和相关结局。

方法

数据来自 1996 年至 2006 年期间的英国“医院入院统计数据库”。主要研究结果是 30 天总体和 1 年死亡率、28 天再入院率和超过第 75 百分位数(中位数住院时间=6 天)的延长住院时间(LOS)。采用多因素逻辑回归分析确定这些结局的独立预测因素。

结果

在研究期间,英国共记录了 560281 例以憩室疾病为主要诊断的入院病例。全国入院率从 0.56 增加到 1.20/1000 人/年。232047 例(41.4%)为住院入院,其中 55519 例(23.9%)为择期入院,176528 例(76.1%)为急诊入院。37767 例(16.3%)接受了手术。30 天死亡率为 5.1%(n=6735),1 年死亡率为 14.5%(n=11567)。28 天再入院率为 9.6%(n=21160)。年龄增长、合并症和急诊入院是所有主要结局的独立预测因素。

结论

在研究过程中,憩室疾病的入院人数有所增加。应识别年龄不断增长、急诊入院和存在严重合并症的患者,以便调整管理以优化结局。

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