INCIDENCE OF AND SURVIVAL FOLLOWING DIVERTICULAR ABSCESS: A POPULATION-BASED COHORT STUDY FROM ENGLAND

Background Diverticular abscess represents a significant complication of diverticular disease. We aimed to provide population based estimates of the incidence of diverticular abscess and assess variation by age, calendar time, treatment and sex. Methods We undertook a historical cohort study using linked primary and secondary care data from 2000–2013 from England. We identified cases of diverticular abscess older than 18 years, calculated incidence rates, and modelled variation using Poisson regression along with estimating one year survival with life tables. Results We identified 622 cases with an overall incidence of 1.9 per 1 00 000 person years (pyrs) (interquartile range (IQR) 1.7–2.0 per 1 00 000 pyrs). Over the time period of the study there was a 1.5 fold increase in the incidence of diverticular abscess (adjusted IRR 1.5, 95% CI 1.0–2.5). This increase was seen in conjunction with an increased use of diagnostic imaging with 92.2% having a CT in 2013 compared to 60% in 2007 (p=0.003). One year survival was 80.1% (95% CI, 76.7%–83.1%) overall and was lowest in those undergoing surgery 68.7%% (95% CI 60.3%–75.7%). Conclusions There has been a 1.5 fold increase in the incidence of diverticular abscess from 2000 to 2013. The condition is associated with a poor one year survival especially following surgery. This increase in incidence may in part be due to improved identification of cases due to an increased use of imaging.