Emergency department presentation, admission, and surgical intervention for colonic diverticulitis in the United States

• The majority of patients presenting for ED treatment of diverticulitis in 2010 were younger than 65.
• Fully 13% of patients presenting for ED treatment of diverticulitis were younger than 40.
• A significant association between patient age and sex was observed, with younger diverticulitis patients more likely to be male and older patients more likely to be female.
• More than half of all patients presenting to the ED with a primary diagnosis of diverticulitis were admitted to inpatient care.
• Surgical intervention was relatively uncommon, even among patients in the oldest age group.

BackgroundDiverticulitis in admitted inpatients is well reported. This study examined colonic diverticulitis treated in the emergency department (ED).MethodsThe 2010 Nationwide Emergency Department Sample was used to examine relationships among patient age and inpatient admission, surgical intervention, and in-hospital mortality among ED patients with a primary diagnosis of diverticulitis.ResultsOf 310,983 ED visits for primary diverticulitis, 53% resulted in hospitalization and 6% in surgical intervention. Most patients 65+ years old were female (69%), and most were hospitalized (63%). Seven percent of ED patients aged 65+ underwent surgery and .96% died in hospital. Patients aged less than 40 years (13% of all admissions) were mostly male (63%), 42% were hospitalized, 4% underwent surgery, and less than .01% died. Compared with patients aged less than 40 years, those 65+ demonstrated greater odds of admission (odds ratio 1.53, 95% confidence interval 1.43 to 1.64) and surgical intervention (odds ratio 1.45, 95% confidence interval 1.27 to 1.65).ConclusionsHalf of ED patients were hospitalized and 6% of ED visits resulted in colectomy. Fully 13% of ED patients were less than 40 years old. Future studies examining outpatient services may further illuminate the epidemiology of diverticulitis.