Reynolds I S, O'Connell E, Heaney R M, Khan W, Khan I Z, Waldron R, Barry K
Department of Surgery, Mayo University Hospital, Castlebar, Co Mayo, Ireland.
Discipline of Surgery, National University of Ireland Galway, Galway, Ireland.
Ir J Med Sci. 2018 Feb;187(1):59-64. doi: 10.1007/s11845-017-1632-x. Epub 2017 May 25.
The treatment paradigm for acute diverticulitis is changing. There is an increasing trend towards managing patients with uncomplicated diverticulitis in the community.
The aim of this study was to analyse how acute diverticulitis is managed in our institution and also to analyse national data pertaining to treatment of acute diverticulitis.
A prospective database of all patients admitted to our institution over a 2-year period (2014-2016) with acute diverticulitis was maintained. Severity of disease, treatment received and average length of stay (LOS) were analysed for all patients. Contemporaneous hospital inpatient enquiry (HIPE) data was interrogated to analyse current management for acute diverticulitis at a national level.
One hundred twenty-six patients were admitted to our institution with acute diverticulitis during the study period (inpatient stay = €1277/night). Of patients, 59.5% had uncomplicated diverticulitis while 40.5% had complicated disease. The median LOS was 4 (range 1-34) days and 8 (range 2-51) days in the uncomplicated and complicated group, respectively. Based on HIPE data, there were 11,357 patients with uncomplicated diverticulitis and 526 patients with complicated diverticulitis admitted to Irish hospitals in the year 2015. Nationally, the median LOS for those with uncomplicated diverticulitis was 3 (range 1-142) days and for those with complicated diverticulitis the median LOS was 7 (range 1-308) days. Projected total cost for hospital stay nationally for uncomplicated diverticulitis amounted to €43.5 million for the year 2015.
At present, uncomplicated diverticulitis in Ireland is not being managed as per evidence-based guidelines. Changing practice could result in significant cost savings for surgical departments.
急性憩室炎的治疗模式正在发生变化。在社区中，对无并发症憩室炎患者进行管理的趋势日益增加。
本研究的目的是分析我院如何管理急性憩室炎患者，并分析与急性憩室炎治疗相关的全国数据。
维护了一个前瞻性数据库，记录了我院在2年期间（2014 - 2016年）收治的所有急性憩室炎患者。分析了所有患者的疾病严重程度、接受的治疗以及平均住院时间（LOS）。查询了同期医院住院患者查询（HIPE）数据，以分析全国范围内急性憩室炎的当前管理情况。
在研究期间，我院有126例患者因急性憩室炎入院（住院费用=1277欧元/晚）。其中，59.5%的患者患有无并发症憩室炎，40.5%的患者患有复杂性疾病。无并发症组和复杂性疾病组的中位住院时间分别为4天（范围1 - 34天）和8天（范围2 - 51天）。根据HIPE数据，2015年爱尔兰医院收治了11357例无并发症憩室炎患者和526例复杂性憩室炎患者。在全国范围内，无并发症憩室炎患者的中位住院时间为3天（范围1 - 142天），复杂性憩室炎患者的中位住院时间为7天（范围1 - 308天）。2015年全国无并发症憩室炎住院的预计总费用达4350万欧元。
目前，爱尔兰无并发症憩室炎的管理未遵循循证指南。改变做法可为外科部门节省大量成本。
