Department of Geriatric Medicine, University of Auckland, C/-Waitemata District Health Board, PO Box 93 503, Takapuna, Auckland, New Zealand.
Department of Surgery, University of Auckland and Auckland District Health Board, Auckland, New Zealand.
Tech Coloproctol. 2019 Aug;23(8):713-721. doi: 10.1007/s10151-019-02040-8. Epub 2019 Aug 8.
Older age has long been linked to risk of diverticulitis, but the epidemiology is seldom described for a national population. The aim of this study was to investigate age- and gender differences in incidence, temporal trends, lifetime risk and prevalence related to acute diverticulitis hospitalisations in New Zealand.
Records of all hospitalisations with diverticulitis the primary diagnosis were obtained from the Ministry of Health for the period 2000-2015. The first acute diverticulitis admission recorded for an individual was taken as an incident event; all others were classified as recurrent. Trends in age- and sex-specific and age-standardised incidence rates are described, and lifetime risk and prevalence estimated.
Over the 16 years from 2000 to 2015, 37,234 acute hospitalisations for diverticulitis were recorded in 28,329 people aged 30 + years (median = 66 years). Rates of incident hospitalisations rose with age, from 5/10,000 person-years at age 50-54 years to 19/10,000py by age 80-84 years. Rates for women were lower than men before age 55 years, but higher thereafter. Age-standardised rates rose 0.2/10,000py annually, but approximately doubled among men aged < 50 years. Lifetime risk was estimated at over 5%, with the prevalence pool rising to over 1.5% of the population aged 30+ in 2030.
Rapid increases in diverticulitis admissions among young men since 2000 correspond with increases reported elsewhere but remain unexplained; notably young women follow similar trends 5-10 years later. Increasing incidence, combined with population ageing, adds urgency to explain diverticular formation, to understand factors that trigger or provoke their inflammation/infection, and to clarify treatment and (self-)management pathways.
年龄较大一直与憩室炎的风险相关，但很少有针对全国人口的流行病学描述。本研究的目的是调查新西兰急性憩室炎住院患者的年龄和性别差异、发病率、时间趋势、终生风险和患病率。
从卫生部获得了 2000 年至 2015 年期间所有以憩室炎为主要诊断的住院记录。将记录中个人首次急性憩室炎入院记录为一个事件；其余的则归类为复发性。描述了年龄和性别特异性和年龄标准化发病率趋势，并估计了终生风险和患病率。
在 2000 年至 2015 年的 16 年中，在 28329 名 30 岁及以上的人群中记录了 37234 例急性憩室炎住院治疗（中位数=66 岁）。发病率随着年龄的增长而上升，从 50-54 岁年龄组的每 10000 人年 5 例增加到 80-84 岁年龄组的每 10000 人年 19 例。在 55 岁之前，女性的发病率低于男性，但之后则高于男性。年龄标准化发病率每年上升 0.2/10000 人年，但 50 岁以下男性的发病率增加了一倍。终生风险估计超过 5%，到 2030 年，30 岁以上人群的患病率将超过 1.5%。
自 2000 年以来，年轻男性憩室炎住院人数的快速增加与其他地方报告的增加相对应，但原因仍不清楚；特别是年轻女性在 5-10 年后也出现了类似的趋势。发病率的增加，加上人口老龄化，迫切需要解释憩室形成的原因，了解触发或引发其炎症/感染的因素，并阐明治疗和（自我）管理途径。
