(058) Surgery for Chronic Diverticular Disease - Incidence and Predictors

Background: Incidence of diverticular disease (DD) is increasing, especially in younger persons, and recurrence is common. Surgical treatment regimens in recurrent or chronic disease have changed towards an individualized approach.

Objectives: This study investigates the incidence of surgery in patients with chronic DD and explores predictors of surgery.

Methods: This cohort study used Danish national healthcare data to identify all patients with chronic DD from 1996 to 2021. Index date was the date of the second hospital contact due to DD. Incidence of surgery due to DD was calculated as cumulative incidence proportions (CIP), treating death as competing risk. Predictors for surgery were explored in a Cox proportional hazard model.

Results: A total of 38,905 patients were diagnosed with chronic DD. Incidence rate of surgery was 6.7 per 100,000 person-years (95% CI: 6.6-6.9). The overall 10-year CIP of surgery was 16% (elective 10%, emergency 6%). The incidence of surgery overall decreased with higher age (HR 0.44 (95% CI 0.40; 0.49) in age 80+ compared to < 50) and over the study period (HR 0.78 (95% CI 0.72; 0.85) in 2015-2021 compared to 1994-2000). Comorbid patients were less likely to undergo surgery than those with little or no comorbidity (HR 0.83 (95% CI 0.76; 0.90)).

Conclusions: Incidence of surgery in chronic DD has decreased over recent decades. Patients with chronic DD that undergo surgery are most likely to undergo elective surgery and less likely to undergo surgery if they were old or comorbid.