Acute colonic diverticulitis may be simple or very complicated.
Not much is understood about what factors determine severity and answering this question may have therapeutic implications.
Dr John W. Lorimer and Dr Gaby Doumir from Canada performed a retrospective review, consisting of teaching hospital admissions for simple or complicated acute diverticulitis.
| A major degree of comorbidity was strongly associated with complicated disease |
| The American Journal of Surgery |
The intent was to identify characteristics of, and differences between, the 2 groups.
The Charlson index was used to assess states of preexisting health (comorbidity).
In multivariate analysis, the presence of a major degree of comorbidity (Charlson score 3 or greater) was strongly associated with complicated disease (P = 0.02) as was the use of nonsteroidal anti-inflammatory drugs (P = .01).
Deaths were not seen below the age of 50, and high Charlson score also strongly predicted mortality (P < .0001).
There were significant differences between patients presenting with simple and complicated diverticulitis, and the amount of associated comorbidity (as measured by Charlson score) appears to be a major one.
Dr Lorimer concluded that, "Because of the high mortality seen in patients with Charlson scores 3 or greater and complicated diverticulitis, we believe that an early surgical approach should be considered for them, particularly if they are 50 or older".