| Title |
The Decline of Elective Colectomy Following Diverticulitis
|
|---|---|
| Published in |
Diseases of the Colon & Rectum, April 2016
|
| DOI | 10.1097/dcr.0000000000000561 |
| Pubmed ID | |
| Authors |
Debbie Li, Nancy N. Baxter, Robin S. McLeod, Rahim Moineddin, Avery B. Nathens |
| Abstract |
The indications for interval elective colectomy following diverticulitis are unclear; evidence lends increasing support for nonoperative management. This study aims to evaluate the temporal trends in the use of elective colectomy following diverticulitis. This is a population-based retrospective cohort study using administrative discharge data. This study was conducted in Ontario, Canada. Patients who had had an episode of diverticulitis managed nonoperatively and were eligible for elective colectomy, from 2002 to 2012, were selected. Changes in the proportion of patients who undergo elective colectomy following an episode of diverticulitis treated nonoperatively were evaluated. Cochran-Armitage was used to test for trends; adjusted analysis was performed by using multivariable logistic regression with generalized estimating equations. A total of 14,124 patients were admitted with an episode of diverticulitis and treated nonoperatively, making them eligible for interval elective colectomy. Median follow-up was 3.9 years (maximum, 10; interquartile range, 1.7-6.4). Overall, 1342 (9.5%) patients underwent elective colectomy; 33% of these colectomies were performed laparoscopically, and 7.5% patients received an ostomy. In-hospital mortality was 0.2%. The majority (76%) of elective operations were performed within 1 year of discharge (median, 160 days; interquartile range, 88-346). The proportion of patients undergoing elective colectomy within 1 year of discharge declined from 9.6% of patients in 2002 to 3.9% by 2011 (p < 0.001). The decline was most pronounced in patients <50 years of age (from 17% to 5%), and those with complicated disease (from 28% to 8%) (all p < 0.001). In multivariable regression, younger age, lower medical comorbidity, complicated disease, and early readmission were associated with elective colectomy. After adjusting for changes in patient characteristics, the odds of elective surgery decreased by 0.93 per annum (adjusted OR; 95% CI, 0.90-0.95). Administrative health databases contain limited clinical detail; the rationale for elective surgery was not available. Consistent with evolving practice guidelines, there has been a decrease in the use of elective colectomy following an episode of diverticulitis. |
X Demographics
The data shown below were collected from the profiles of 15 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Mexico | 2 | 13% |
| Ecuador | 1 | 7% |
| France | 1 | 7% |
| Brazil | 1 | 7% |
| United States | 1 | 7% |
| Italy | 1 | 7% |
| United Kingdom | 1 | 7% |
| Argentina | 1 | 7% |
| New Zealand | 1 | 7% |
| Other | 0 | 0% |
| Unknown | 5 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 7 | 47% |
| Practitioners (doctors, other healthcare professionals) | 5 | 33% |
| Scientists | 2 | 13% |
| Science communicators (journalists, bloggers, editors) | 1 | 7% |
Mendeley readers
The data shown below were compiled from readership statistics for 22 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 1 | 5% |
| Unknown | 21 | 95% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 5 | 23% |
| Student > Doctoral Student | 4 | 18% |
| Other | 2 | 9% |
| Student > Postgraduate | 2 | 9% |
| Student > Master | 1 | 5% |
| Other | 2 | 9% |
| Unknown | 6 | 27% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 11 | 50% |
| Pharmacology, Toxicology and Pharmaceutical Science | 1 | 5% |
| Agricultural and Biological Sciences | 1 | 5% |
| Computer Science | 1 | 5% |
| Unknown | 8 | 36% |
Attention Score in Context
This research output has an Altmetric Attention Score of 13. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 22 November 2019.
All research outputs
#2,473,185
of 23,314,015 outputs
Outputs from Diseases of the Colon & Rectum
#587
of 4,445 outputs
Outputs of similar age
#41,942
of 301,387 outputs
Outputs of similar age from Diseases of the Colon & Rectum
#4
of 59 outputs
Altmetric has tracked 23,314,015 research outputs across all sources so far. Compared to these this one has done well and is in the 89th percentile: it's in the top 25% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 4,445 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.6. This one has done well, scoring higher than 86% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 301,387 tracked outputs that were published within six weeks on either side of this one in any source. This one has done well, scoring higher than 86% of its contemporaries.
We're also able to compare this research output to 59 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 94% of its contemporaries.