Influence of Age on Clinical Outcome of Acute Diverticulitis

The controversy about the treatment of acute colonic diverticulitis in young patients continues. The discussion is focused on whether younger age is a risk factor for recurrence or a complicated course, thereby subject to different treatment choices.

In this study, we investigated whether an episode of acute diverticulitis at a younger age (≤50 years) has a higher recurrence rate or a more severe outcome.

A retrospective cohort study was conducted in four teaching hospitals using hospital registry codes for diverticulitis. All patients diagnosed with acute diverticulitis between January 2004 and January 2012, confirmed by imaging, were included.

A total of 1,441 consecutive patients were identified as having primary acute diverticulitis of the sigmoid colon. Four hundred and sixty-three patients (32.1 %) were ≤50 years (group 1) and 978 patients (67.9 %) were older than 50 years (group 2). Twenty patients (4.3 %) needed emergency surgery, due to perforated diverticulitis, within 72 h at first presentation in group 1 compared to 77 patients (7.8 %) in group 2 (p = 0.029). Surgery within 30 days was needed for 29 of 463 patient (6.2 %) in group 1 and 104 of 978 patients (10.6 %) in group 2 (p = 0.02). Recurrence rate after a median follow-up of 22 months was comparable among groups (25.6 % (111 patients) in group 1 versus 23.8 % (208 patients) in group 2; p = 0.278). Also, cumulative recurrence was comparable among groups.

Younger age is neither associated with a more severe presentation of diverticulitis nor with a higher incidence in recurrence.