Incidence of perforated diverticulitis and risk factors for death in a UK population.

BACKGROUND: Perforated diverticulitis (PD) remains a serious acute abdominal condition. The aims of this study were to measure its incidence in a large UK population and to identify factors affecting outcomes.

METHODS: Computerized searches of hospital coding databases for PD were performed in five hospitals in East Anglia, UK. Data were collected from hospital records over 5 years (1995-2000). Incidence was calculated using population data, and factors associated with mortality and morbidity were identified using univariable and multivariable testing.

RESULTS: Some 202 patients with PD were identified, of whom 93.1 per cent underwent surgery and 24.3 per cent died. The age-adjusted adult incidence of perforation was 3.5 per 100 000 per annum, with a standardized female to male ratio of 1.3 (95 per cent confidence interval (c.i.) 1.1 to 1.5) to 1. Risk factors for death were increased age (odds ratio (OR) 3.5 (95 per cent c.i. 1.9 to 6.1)), pre-existing renal disease (OR 18.7 (1.6 to 211.4)) and pre-existing use of non-steroidal anti-inflammatory drugs (NSAIDs) (OR 3.1 (1.3 to 7.3)).

CONCLUSION: PD is uncommon, with the highest incidence in women over 65 years old. Mortality rates are high, particularly in those taking NSAIDs or with pre-existing renal impairment.