OBJECTIVES: We documented the clinical characteristics, treatment patterns, and resource utilization associated with diverticulitis in a real-world European population.
METHODS: Data were abstracted from medical charts of 1,509 patients in 5 countries (~300 per country): United Kingdom, Germany, France, Netherlands, and Spain. Inclusion criteria were: diagnosed with diverticulitis during Jnuary 1, 2007–September 30, 2010; aged =18 years at first (index) diagnosis; no history of colon cancer; not enrolled in diverticulitis-related clinical trial; and =12 months of chart history after index diagnosis. Study measures were evaluated over all available post-index follow-up (=12 months).
RESULTS: Mean [SD] age at index was 61.7 [11.2] years and 55% of patients were male. Diagnosis setting was evenly distributed by general practitioner (29%), specialist (24%), emergency (24%), and hospital (22%). Diabetes was the most common chronic comorbidity (23% of patients) and 20% of patients were considered obese. More than half of patients presented with or subsequently developed diverticulitis-related complications, most commonly fissure/abscess/fistula (23%) or lower gastrointestinal (GI) hemorrhage (14%). Peritonitis, a life-threatening infection, was seen in 8.4% of patients. One-fifth (~20%) of patients did not receive antibiotics or other pharmacotherapies (i.e., aminosalicylates, analgesics, other GI drugs) used to manage diverticulitis and its symptoms. Among patients managed by office-based physicians (n=753), oral antibiotics and aminosalicylates (72% and 68% of patients, respectively) were the common treatments. Among those managed by hospital-based physicians (n=756), aminosalicylates were infrequently prescribed (11% of patients) and intravenous antibiotics were preferred over oral (67% and 36%, respectively). Fifty-seven percent of patients were hospitalized, with the majority being for acute disease management or diagnostics. Among those hospitalized, mean [SD] length of stay was 12.6 [31.8] days.
CONCLUSIONS: Diverticulitis presents a significant disease burden to health care systems and patients in Europe. Many patients with diverticulitis present with or develop serious complications, leading to frequent hospitalization and long hospital stays.