Risk factors for recurrence and complications in acute uncomplicated diverticulitis: A retrospective cohort study

Introduction Antibiotics for acute uncomplicated diverticulitis (AUD) have been questioned in several studies. Thus, it is of value to identify risk factors for recurrence and complications to identify the best strategy for treatment. The aim was to investigate risk factors for recurrence and complications within at least 1 year after hospitalization for AUD. Methods This is a retrospective study, including patients hospitalized with AUD at Helsingborg Hospital and Skåne University Hospital in Sweden during January 1st, 2015–December 31st, 2017. The cohort was primarily collected via the in-patient registry. Patients with multiple registrations, acute complicated diverticulitis, ongoing antibiotics, other diagnoses, immunosuppression and non-CT-verified diagnosis were excluded. Follow-up was ≥1 year. SPSS was used for statistical analysis. Results Out of 596 patients, 23% experienced recurrences and 3% experienced complications. Previous diverticulitis [OR 2.86 (CI 1.85–4.55) P < 0.001] and complications [OR 1.35 (CI 1.18–1.42) P < 0.001] were independent risk factors for recurrence. A higher Charlson morbidity index (CMI) [OR 1.27 (1.0–1.61) P = 0.04] and previous diverticulitis [OR 3.68 (1.24–10.9) P = 0.013] were associated with complications. 75% of the patients received antibiotics but this did not significantly improve outcomes. Conclusion A history of previous diverticulitis or complications increases the risk for AUD recurrence. A higher CMI and a history of previous diverticulitis may be risk factors for complications but needs to be further assessed. Treatment with antibiotics does not appear to improve the outcome. Choice of treatment should therefore be individualized and based on risk factors for complications and recurrence.