ArticleCanadian journal of surgery. Journal canadien de chirurgie2016
Diverticulitis in immunosuppressed patients: A fatal outcome requiring a new approach?
Article in Canadian journal of surgery. Journal canadien de chirurgie, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 24 citations in OpenAlex.
- Evidence-based clinical practice guidelines for diagnosis and medical management of acute colonic diverticulitis developed by the Korean Association for the Study of Intestinal Diseases (KASID).Intestinal research · 2026Review
- Diverticulitis Management in Complex Medical Contexts.Clinics in colon and rectal surgery · 2025Review
- Comparative outcomes of acute colonic diverticulitis in immunocompromised versus immunocompetent patients: a systematic review and meta-analysis.Intestinal research · 2023Article
- Acute diverticulitis in immunocompromised patients: evidence from an international multicenter observational registry (Web-based International Register of Emergency Surgery and Trauma, Wires-T).Techniques in coloproctology · 2023Article
- Paradox inflammatory reaction such as appendicitis epiploica and diverticulitis of the sigmoid colon under ongoing immunosuppression after previous liver transplantation (LTx).Innovative surgical sciences · 2023Article
- Article
- Colonic diverticular disease in autosomal dominant polycystic kidney disease: is there really an association? A nationwide analysis.International journal of colorectal disease · 2021Article
- Diverticulitis: An Update From the Age Old Paradigm.Current problems in surgery · 2020Review
- The Effect of Immunosuppression on Emergency Colectomy Outcomes: A Nationwide Retrospective Analysis.World journal of surgery · 2020Article
- Association between diverticular disease requiring surgical intervention and mortality in the postlung transplant population - a retrospective cohort study.Transplant international : official journal of the European Society for Organ Transplantation · 2019Article
- Epidemiology and Pathophysiology of Diverticular Disease.Clinics in colon and rectal surgery · 2018Review
Corrections and comments
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Authors and funding
12 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiagnosis and treatment of diverticulitis in immunosuppressed patients are more challenging than in immunocompetent patients, as maintenance immunosuppressive therapies may mask symptoms or impair the patient's ability to counteract the local and systemic infective sequelae of diverticulitis. The purpose of this study was to compare the in-hospital mortality and morbidity due to diverticulitis in immunosuppressed and immunocompetent patients and identify risk factors for lethal outcomes.
methodsThis retrospective study included consecutive in-patients who received treatment for colonic diverticulitis at our institution between April 2008 and April 2014. Patients were divided into immunocompetent and immunosuppressed groups. Primary end points were mortality and morbidity during treatment. Risk factors for death were evaluated.
resultsOf the 227 patients included, 15 (6.6%) were on immunosuppressive therapy for solid organ transplantation, autoimmune disease, or cerebral metastasis. Thirteen of them experienced colonic perforation and showed higher morbidity (p = 0.039). Immunosuppressed patients showed longer stays in hospital (27.6 v. 14.5 d, p = 0.016) and in the intensive care unit (9.8 v. 1.1 d, p < 0.001), a higher rate of emergency operations (66% v. 29.2%, p = 0.004), and higher in-hospital mortality (20% v. 4.7%, p = 0.045). Age, perforated diverticulitis with diffuse peritonitis, emergency operation, C-reactive protein > 20 mg/dL, and immunosuppressive therapy were significant predictors of death. Age (hazard ratio [HR] 2.57, p = 0.008) and emergency operation (HR 3.03, p = 0.003) remained significant after multivariate analysis.
conclusionMorbidity and mortality due to sigmoid diverticulitis is significantly higher in immunosuppressed patients. Early diagnosis and treatment considering elective sigmoid resection for patients with former episodes of diverticulitis who are wait-listed for transplant is crucial to prevent death.
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