Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA.
Department of Emergency Medicine, Rush University Medical Center, Chicago, IL, USA.
Am J Emerg Med. 2024 Dec;86:83-86. doi: 10.1016/j.ajem.2024.10.002. Epub 2024 Oct 5.
Diverticulitis is a common reason for presentation to the Emergency Department (ED). However, as imaging options, risk stratification tools, and antibiotic options have expanded, there is a need for current data on the changes in incidence, computed tomography (CT) performance, antibiotic usage, and disposition over time.
This was a cross-sectional study of ED patients with a diagnosis of diverticulitis from 1/1/2016 to 12/31/2023. Using the Epic Cosmos database, all ED visits for acute diverticulitis were identified using ICD-10 codes. Outcomes included total ED presentations for diverticulitis, admission rates, CTs performed, outpatient antibiotic prescriptions, and antibiotics administered in the ED for admitted patients.
There were 186,138,130 total ED encounters, with diverticulitis representing 927,326 (0.50 %). The rate of diverticulitis diagnosis increased from 0.40 % to 0.56 % over time. The admission rate declined over time from 33.6 % to 27.7 %, while the CT rate rose from 83.0 % to 92.6 %. Among those discharged, 90.4 % received an antibiotic, which remained consistent over time. Metronidazole (55.1 %) and ciprofloxacin (40.8 %) were the most commonly prescribed antibiotics, followed by amoxicillin-clavulanate (36.1 %). Among those admitted, most received either metronidazole (62.0 %), a fluoroquinolone (40.4 %), a third-generation cephalosporin (18.9 %), or a penicillin-based agent (38.1 %). Among both discharged and admitted patients, there was a marked shift to penicillin-based agents as the primary antibiotic regimen.
Diverticulitis remains a common ED presentation, with a gradually rising incidence over time. Admission rates have decreased, while CT imaging has become more common. Most patients receive antibiotics, though the specific antibiotic has shifted in favor of penicillin-based agents. These findings can provide key benchmarking data and inform future initiatives to guide imaging and antibiotic use.
憩室炎是急诊科就诊的常见原因。然而，随着影像学选择、风险分层工具和抗生素选择的增加，需要了解发病率、计算机断层扫描 (CT) 表现、抗生素使用和随时间推移的处置方式的变化的最新数据。
这是一项回顾性研究，纳入了 2016 年 1 月 1 日至 2023 年 12 月 31 日期间因憩室炎在急诊科就诊的患者。使用 Epic Cosmos 数据库，使用 ICD-10 代码确定所有急性憩室炎的急诊科就诊。主要结局包括因憩室炎在急诊科就诊的总人数、住院率、进行的 CT 检查、门诊抗生素处方和收治患者在急诊科使用的抗生素。
共有 186138130 例急诊科就诊，其中憩室炎患者 927326 例（0.50%）。憩室炎的诊断率呈上升趋势，从 0.40%升至 0.56%。住院率呈下降趋势，从 33.6%降至 27.7%，而 CT 率从 83.0%升至 92.6%。在出院患者中，90.4%接受了抗生素治疗，且该比例在整个研究期间保持稳定。甲硝唑（55.1%）和环丙沙星（40.8%）是最常用的抗生素，其次是阿莫西林克拉维酸（36.1%）。在收治患者中，大多数患者接受的是甲硝唑（62.0%）、氟喹诺酮类药物（40.4%）、三代头孢菌素（18.9%）或青霉素类药物（38.1%）。在出院和收治患者中，主要抗生素方案明显转向青霉素类药物。
憩室炎仍是急诊科常见的就诊原因，发病率随时间逐渐上升。住院率下降，而 CT 成像更为常见。大多数患者接受抗生素治疗，但具体抗生素已转向以青霉素类药物为主。这些发现可以提供关键的基准数据，并为未来的影像学和抗生素使用指导倡议提供信息。
