Division of General Surgery, Department of Surgery, University of Utah, Salt Lake City, Utah, United States.
Department of Surgery, University of Utah, Salt Lake City, Utah, United States.
J Gastrointest Surg. 2024 Apr;28(4):507-512. doi: 10.1016/j.gassur.2023.12.028. Epub 2024 Feb 9.
The risk of recurrence is an important consideration when deciding to treat patients medically or with elective colectomy after recovery from diverticulitis. It is unclear whether age is associated with recurrence. This study aimed to examine the relationship between age and the risk of recurrent diverticulitis while considering important epidemiologic factors, such as birth decade.
The Utah Population Database was used to identify individuals with incident severe diverticulitis, defined as requiring an emergency department visit or hospitalization, between 1998 and 2018. This study measured the relationship between age and recurrent severe diverticulitis after adjusting for birth decade and other important variables, such as sex, urban/rural status, complicated diverticulitis, and body mass index using a Cox proportional hazards model.
The cohort included 8606 individuals with a median age of 61 years at index diverticulitis diagnosis. After adjustment, among individuals born in the same birth decade, increasing age at diverticulitis onset was associated with an increased risk of recurrent diverticulitis (hazard ratio [HR] for 10 years, 1.8; 95% CI, 1.5-2.1). Among individuals with the same age of onset, those born in a more recent birth decade were also at greater risk of recurrent diverticulitis (HR, 1.9; 95% CI, 1.6-2.3).
Among individuals with an index episode of severe diverticulitis, recurrence was associated with increasing age and more recent birth decade. Clinicians may wish to employ age-specific strategies when counseling patients regarding treatment options after a diverticulitis diagnosis.
在决定对憩室炎患者进行药物治疗还是择期结肠切除术时,复发风险是一个重要的考虑因素。目前尚不清楚年龄是否与复发有关。本研究旨在探讨年龄与复发性憩室炎之间的关系,同时考虑了重要的流行病学因素,如出生年代。
本研究使用犹他州人群数据库,确定了 1998 年至 2018 年期间发生严重憩室炎(定义为需要急诊就诊或住院治疗)的个体。本研究使用 Cox 比例风险模型,在调整出生年代和其他重要变量(如性别、城乡状况、复杂憩室炎和体重指数)后,测量了年龄与复发性严重憩室炎之间的关系。
队列纳入了 8606 名个体,其首次憩室炎诊断时的中位年龄为 61 岁。在调整后,在出生于同一年代的个体中,憩室炎发病时的年龄越大,复发憩室炎的风险越高(每增加 10 岁的风险比 [HR],1.8;95%CI,1.5-2.1)。在发病年龄相同的个体中,出生于较晚年代的个体也更易发生复发性憩室炎(HR,1.9;95%CI,1.6-2.3)。
在首次发生严重憩室炎的个体中,复发与年龄增长和出生年代较晚有关。临床医生在为憩室炎患者提供治疗选择的咨询时,可能希望采用年龄特异性策略。