Abstract :
Background & Aims: There was limited epidemiological information that described the current characteristic
and outcomes associated to colonic diverticular disease in Thailand. This study aimed to investigate
patient characteristic and identify factors related to poor outcome for patients which admitted with diverticular
diseases (DD).
Methods: Retrospective cohort study, data from 2000 to 2010 were obtained from the electronic database
(Digicard) of Maharaj Nakorn Chiang Mai Hospital. The predictors of mortality were identified by using
multiple logistic regression analysis and Cox regression analysis.
Results: The 195 patients with a primary diagnosis of DD were recruited. The mean age was 62.3 ±
16.2. The 30-day mortality rate occurred in 3.6%, 1-year mortality in 9.2% and cumulative mortality in 21.5%.
Extended LOS was identified as an independent predictor of 1-year all-caused mortality and cumulative mortality
(OR 25.25, p < 0.0001 and OR 3.624, p = 0.007 respectively). Charlson index more than 4 and SIRS were also to be
the independent predictive of cumulative mortality. Subgroup of diverticular bleeding, extended LOS was identified
as an independent predictor of 1-year mortality (OR 12.16, p = 0.007 = 0.046-year mortality (OR 6.84s higher
in patients with more Charlson index score (P= ). Subgroup of diverticulits, AKI and hypoalbuminemia were
identified as an independent predictor of 1-year mortality (OR 6.84, p = 0.044 and OR 10.35, p = 0.046). The
independent predictor of cumulative mortality is hypoalbuminemia (OR 11.47, p = 0.001). The independent predictors
for diverticular-related mortality were extended LOS (OR 11.00, p = 0.034) and operation (OR 10.51, p =
0.037).
Conclusion: Number of admission for diverticular disease increased in Thailand. Right-sided diverticular
disease in Thailand found less than other studies from Asian countries. The extended LOS, SIRS, hypoalbuminemia
and increased comorbidity are predictors for poor outcome. |
file/Thai-Journal-of-gastroenterology-vol-14-no-3-3318257.pdf