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.
