Diagnostic and treatment outcomes of acute colonic diverticulitis in 2013 -2017.

Aim: to evaluate diagnostic and treatment outcomes of acute colonic diverticulitis in LUHS Kaunas Clinics. Tasks: 1. To evaluate demographic data changes in patients with acute colonic diverticulitis in 2013 - 2017. 2. To evaluate diagnostic changes in patients with acute colonic diverticulitis. 3. To evaluate methods and changes of treatment in patients with acute colonic diverticulitis. 4. To evaluate an effect of different factors (age, comorbidity, CRP, computer tomography, Hinchey stages) on treatment outcomes. Methodics: The retrospective study included all medical documentation of patients who were urgently stationarized in LUHS in 2013 - 2017 because of acute colonic diverticulitis. We excluded patients who came for elective operation. We also excluded patients who presented with small intestine diverticulitis, chronic diverticulitis, diverticulosis, gastrointestinal bleeding and those with a history of colorectal cancer, colectomy or metastases in abdomen. All patients were divided into conservative and surgical treatment groups. We analyzed demographic data, episode of disease, CRP, stages of Hinchey, methods of treatment, comorbidity, bed-days and mortality. Statistical analysis was performed with the use of SPSS Statistics 25.0 program. ANOVA test was perform to compare statistical significance between means of ages in cualitatitive variables. For categorical variables we applyied Chi (χ2) Pearson or Fisher exact tests. Survival analysis was performed using Kaplan-Meier test. CRP sensitivity and sensibility was analysed by ROC curve. P value less than 0.05 was considered statistically significant. Results: The study consisted of 272 patients, 66,5% of them were women. The mean age of Women was higher 65,4 ± 15,2 than men‘s 57,6 ± 16,2 (p0.05), but it increased among all hospitalised patients. CRP value is specific and sensible to differenciate between complicated and uncomplicated diverticulitis (AUC=0.822, PI 95% (0.765-0.879), P<0.05) and to differenciate between mortality and recovery (AUC=0.846, PI 95% (0.783-0.908), P<0.05). Complicated diverticulitis, Hinchey III and IV stages, age≥60 years, diabetes mellitus except of CT performing increase mortality of patients (p<0.05). In patients older than 50 tendency to have complicated diverticulitis is much higher than for younger patients (p<0.05). Kaplan- Meier survival was statistically significant between Hinchey I and IV (p<0.05), between Hinchey I and III, IV(p<0.05) and between Hinchey II and IV (p