Journal article
Symptomatic Diverticular Disease in Patients With Severely Reduced Kidney Function: Higher Rates of Complications and Transfusion Requirement
Gastroenterology research, v 10(1), pp 15-20
01 Feb 2017
PMID: 28270872
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: The prevalence of diverticulosis is increasing with 5-10% of patients developing diverticulitis and 5-15% developing symptomatic bleeding. Diverticulitis can result in abscess, perforation, fistula, or obstruction. Bleeding has combined morbidity and mortality rates of 10-20%. The purpose of this study was to compare diverticulitis-related complications and transfusion requirements for diverticular bleeding in patients with normal to moderately reduced kidney function (glomerular filtration rate (GFR) >= 30 mL/min/1.73 m(2)) and patients with severe renal impairment (GFR < 30 mL/min/1.73 m(2)), and identify factors associated with these outcomes.
Methods: We retrospectively reviewed records of all patients with diverticulitis and diverticular bleeding treated at our hospital from January 1, 2011 to July 31, 2016. Patients were evaluated for baseline characteristics, GFR, baseline hemoglobin, medications, comorbidities, length of stay (LOS), presence of perforations or abscesses and the need for transfusion.
Results: Of the 291 patients included, males were 167 (58%). Perforations and abscesses complicating diverticulitis developed in 31/136 (23%) of patients with GFR = 30 mL/min/1.73 m(2), and in 13/26 (50%) of patients with GFR < 30 mL/min/1.73 m(2) (odds ratio (OR): 3.4; 95% confidence interval (CI): 1.423 -8.06; P = 0.0073). Mean LOS (days) was 6.3 +/- 4 in the GFR = 30 mL/min/1.73 m(2) group and 8.5 +/- 4.4 in GFR < 30 mL/min/1.73 m(2) group (P = 0.0001). Blood transfusion for diverticular bleeding occurred in 11/78 (14%) of patients with GFR = 30 mL/min/1.73 m(2) and in 22/51 (43%) of patients with GFR < 30 mL/min/1.73 m(2) (OR: 4.6; 95% CI: 1.99 -10.76; P = 0.0004). Among patients who needed transfusion, mean LOS was 8.5 +/- 2.5 in GFR = 30 mL/min/1.73 m(2) group and 9 +/- 5 in those with GFR < 30 mL/min/1.73 m(2) (P = 0.04). There were no differences in age, gender or race between the study groups.
Conclusion: There was a significant increase in complicated diverticulitis cases, transfusion requirements for diverticular bleeding and LOS in patients with severely reduced kidney function compared to patients with normal-moderately reduced renal function.
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Details
- Title
- Symptomatic Diverticular Disease in Patients With Severely Reduced Kidney Function: Higher Rates of Complications and Transfusion Requirement
- Creators
- Ahmed Dirweesh - Seton Hall UniversityAfolarin Amodu - Seton Hall UniversityMuhammad Khan - Seton Hall UniversityRitika Zijoo - Seton Hall UniversityBushra Ambreen - Seton Hall UniversityMohammad Ibrahim - Seton Hall UniversityMuhammad Ijaz - Seton Hall UniversityAbdelhameed Nawwar - Seton Hall UniversityKareem Genena - Seton Hall UniversityMuhammad Tahir - Seton Hall UniversityNaresh Kumar - Seton Hall UniversityVincent A. Debari - Seton Hall UniversitySara Wallach - Seton Hall University
- Publication Details
- Gastroenterology research, v 10(1), pp 15-20
- Publisher
- Elmer Press Inc
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- General Internal Medicine
- Web of Science ID
- WOS:000397223700003
- Other Identifier
- 991021962194104721
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- Web of Science research areas
- Gastroenterology & Hepatology