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2010 Annual Meeting Abstracts

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Is recurrence of diverticulitis different in obese patients?
*Jason F Hall, Patricia L Roberts, *Thomas Read, Rocco Ricciardi, Peter W. Marcello, David Schoetz
Lahey Clinic, Burlington, MA

Objective:
To examine the recurrence of uncomplicated and complicated diverticulitis in persons with a body mass index (BMI) ≥ 30 and BMI < 30, after an initial episode of diverticulitis.
Design:
Retrospective cohort
Setting:
Tertiary care medical center
Patients:
Patients who presented to our institution with diverticulitis from 2002-2008.
Interventions:
Obese (BMI ≥ 30) and non-obese (BMI < 30) groups were compared. Patients with a history of diverticulitis were excluded. Clinical and CT characteristics were compared. Kaplan-Meier analysis was used to determine recurrence rates. Cox proportional hazards modeling was used to adjust for confounding.
Main Outcome Measures:
Recurrent diverticulitis, recurrent complicated diverticulitis.
Results:
753 patients were studied; mean age 61 ± 15 years. 265 (35.19%) were obese. Mean follow-up was 35 ± 25 months. Obese patients presented with initial complicated disease (abscess, fistula, free air, emergency operation) at the same rate as non-obese patients (17% vs. 12%, p < .09). The proportion of patients with a Charlson score ≥ 2 was similar in obese and non-obese groups (44% vs. 45%, p < .65). Overall recurrence of disease was lower in the obese group at 5 years (27% vs.37%, p < .02) Obese patients did not have a significantly lower incidence of complicated recurrence (2.3% vs. 5.2%, p < .08). The crude hazard ratio (HR) for recurrent disease in obese persons was 0.69 [95% CI 0.5 - 0.9]. When adjusted for differences between obese and non-obese patients the HR was 0.54 [95% CI 0.37- 0.81].
Conclusions:
In our study, obesity was not associated with higher rates of complicated disease. Obesity was associated with lower recurrence of diverticulitis following an initial episode. These data may have implications for counseling patients with obesity about elective surgery for diverticulitis.


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