Abstract：
Diverticular disease of the colon occurs commonly in developed countries. Immunosuppressed patients are thought to be more at risk of developing acute diverticulitis, worse disease, and higher complications secondary to therapy. This study aimed to assess outcomes for immunosuppressed patients with acute diverticulitis.
A retrospective single-centre review was conducted of all patients presenting with acute diverticulitis at a major tertiary Australian hospital from 2006 to 2018.
A total of 751 patients, comprising of 46 immunosuppressed patients, were included. Immunosuppressed patients were found to be older (62.25 versus 55.96, p = 0.016), have more comorbidities (median Charlson Index 3 versus 1, P < 0.001), and undergo more operative management (13.3% versus 5.1%, P = 0.020). Immunosuppressed patients with paracolic/pelvic abscesses (Modified Hinchey 1b/2) were more likely to undergo surgery (56% versus 24%, P = 0.046), while in patients with uncomplicated diverticulitis, there was no difference in immunosuppressed patients undergoing surgery (6.1% versus 5.1% P = 0.815). Immunosuppressed patients were more likely to have Grade III-IV Clavien-Dindo complication (P < 0.001).
Immunosuppressed patients with uncomplicated diverticulitis can be treated safely with non-operative management. Immunosuppressed patients were more likely to have operative management for Hinchey 1b/II and more likely to have grade III/IV complications.
A retrospective single-centre review was conducted of all patients presenting with acute diverticulitis at a major tertiary Australian hospital from 2006 to 2018.
A total of 751 patients, comprising of 46 immunosuppressed patients, were included. Immunosuppressed patients were found to be older (62.25 versus 55.96, p = 0.016), have more comorbidities (median Charlson Index 3 versus 1, P < 0.001), and undergo more operative management (13.3% versus 5.1%, P = 0.020). Immunosuppressed patients with paracolic/pelvic abscesses (Modified Hinchey 1b/2) were more likely to undergo surgery (56% versus 24%, P = 0.046), while in patients with uncomplicated diverticulitis, there was no difference in immunosuppressed patients undergoing surgery (6.1% versus 5.1% P = 0.815). Immunosuppressed patients were more likely to have Grade III-IV Clavien-Dindo complication (P < 0.001).
Immunosuppressed patients with uncomplicated diverticulitis can be treated safely with non-operative management. Immunosuppressed patients were more likely to have operative management for Hinchey 1b/II and more likely to have grade III/IV complications.
摘要：
背景：结肠憩室疾病通常发生在发达国家。免疫抑制患者被认为更有可能发生急性憩室炎，更糟糕的疾病,和较高的并发症继发于治疗。本研究旨在评估急性憩室炎免疫抑制患者的预后。
方法：对2006年至2018年澳大利亚一家三级医院所有急性憩室炎患者进行了回顾性单中心回顾。
结果：共有751名患者，包括46名免疫抑制患者，包括在内。发现免疫抑制患者年龄较大（62.25对55.96，p=0.016），有更多的合并症(平均Charlson指数3对1，P<0.001)，并接受更多的手术管理(13.3%对5.1%，P=0.020)。患有结肠旁/盆腔脓肿（改良Hinchey1b/2）的免疫抑制患者更有可能接受手术（56％对24％，P=0.046),而在无并发症的憩室炎患者中，接受手术治疗的免疫抑制患者无差异(6.1%对5.1%P=0.815).免疫抑制患者更容易出现III-IV级Clavien-Dindo并发症(P<0.001)。
结论：免疫抑制的无并发症憩室炎患者可以通过非手术治疗安全地治疗。免疫抑制患者更有可能接受Hinchey1b/II的手术治疗，更有可能出现III/IV级并发症。
方法：对2006年至2018年澳大利亚一家三级医院所有急性憩室炎患者进行了回顾性单中心回顾。
结果：共有751名患者，包括46名免疫抑制患者，包括在内。发现免疫抑制患者年龄较大（62.25对55.96，p=0.016），有更多的合并症(平均Charlson指数3对1，P<0.001)，并接受更多的手术管理(13.3%对5.1%，P=0.020)。患有结肠旁/盆腔脓肿（改良Hinchey1b/2）的免疫抑制患者更有可能接受手术（56％对24％，P=0.046),而在无并发症的憩室炎患者中，接受手术治疗的免疫抑制患者无差异(6.1%对5.1%P=0.815).免疫抑制患者更容易出现III-IV级Clavien-Dindo并发症(P<0.001)。
结论：免疫抑制的无并发症憩室炎患者可以通过非手术治疗安全地治疗。免疫抑制患者更有可能接受Hinchey1b/II的手术治疗，更有可能出现III/IV级并发症。
