Age, BMI and severity of acute diverticulitis: myths or facts?

Introduction: Although it is commonly believed that patients presenting with severe acute diverticulitis are more often obese and elderly, only few evidences are reported in literature about these clinical observations.1,2 In this study, we tried to determine if body mass index (BMI) and old age are associated with a higher incidence of complicated acute diverticulitis. Material and Methods: A retrospective review of patients hospitalized with acute diverticulitis between 2013 and 2015 was conducted. Severity of Acute Diverticulitis was graded in according to modified Hinchey’s classification.3 The mean BMI and mean age for each group of patients were calculated. Statistical analysis was performed by one way anova test with significance set at P<0.05. Results: Charts of 90 patients hospitalized with acute diverticulitis were reviewed. Five groups were identified: 32 patients (36%) were admitted with Hinchey’s stage Ia; 21 (23%) with stage Ib; 20 (22%) with stage II; 12 (13%) with stage III and 5 (6%) with stage IV. Mean BMI and mean age were respectively: 25,45 Kg/m2 (range 40,40-19,10) and 58 years (range 35-87) in group 1; 26,78 Kg/m2 (range 3,33-20,23) and 58 years (range 34-83) in group 2; 26,14 Kg/m2 (range 30,48-22,73) and 63 years (range 49-83) in group 3; 26,68 Kg/m2 (range 34,28-21,25) and 58 years (range 38-87) in group 4; 24,44 Kg/m2 (range 28,3-18,13) and 66 years (range 26-90) in group 5. There was no significant difference among these groups by either age (P=0.762) or BMI (P=0.334). Discussion: Numerous studies have shown a correlation between acute diverticulitis and obesity, particularly in people of advanced age. This retrospective study was undertaken to identify a possible link between BMI, age and complicated acute diverticulitis. No significant differences were recognized, among the groups with different grades of acute diverticulitis, in terms of BMI and age. Despite this result, the aetiological relationship between obesity, old age and diverticular complications still remain unclear