Allegheny General Hospital Pittsburgh, Pennsylvania, United States
Background Diverticulitis is a frequent and often serious condition of the colon, with its complexity increasing in the presence of inflammatory bowel diseases (IBD) such as Crohn's disease (CD) and ulcerative colitis (UC). This study aims to evaluate the impact of IBD on diverticulitis outcomes, focusing on hospitalization rates, surgical interventions, and mortality. Methods We conducted a retrospective analysis of deidentified, aggregate patient data from the TriNetX research network. We used 122,511 diverticulitis patients, identifying those with concurrent CD or UC. Propensity score matching was employed to ensure balanced baseline characteristics between IBD and non-IBD patients, adjusting for variables such as age, gender, comorbidities (e.g., diabetes, chronic kidney disease), and lifestyle factors (e.g., tobacco and alcohol use). Hospitalization rates were calculated based on admissions directly linked to diverticulitis, as tracked in the dataset without distinguishing specific complications. Colectomy rates (both elective and emergency surgeries) and mortality were also assessed. Kaplan-Meier survival curves and Cox proportional hazards models were used to evaluate time-to-event outcomes, including overall survival. Results Out of the 122,511 patients, 1.4% had UC and 1.1% had CD. Compared to non-IBD patients, who had a hospitalization incidence of 9.2%, IBD patients had a substantially higher rate of 15.4% for UC patients and 12.1% for CD patients (p < 0.001). Additionally, IBD patients had higher rates of colectomy (UC: 3.8%, CD: 4.5%) than non-IBD patients (1.7%; p< 0.001). IBD patients had a significantly higher mortality rate than non-IBD patients, with 5.7% of UC patients and 4.9% of CD patients dying from their illness (p < 0.001). According to Kaplan-Meier analysis, IBD patients had a considerably decreased survival rate (p < 0.001), whereas UC patients had the lowest survival results. Conclusion Compared to individuals without IBD, those who have diverticulitis with concomitant IBD—especially UC and CD—had far worse clinical outcomes, including greater rates of hospitalization, colectomy, and death. These findings imply that customized care strategies may be necessary to improve outcomes for diverticulitis in IBD patients, highlighting the need for more monitoring and perhaps more aggressive treatment regimens.
