FP1.5 - Safety and efficacy of Ambulatory treatment of uncomplicated acute diverticulitis: A two-centre cohort study and a proposal of an Ambulatory pathway

Abstract

Abstract Aim This study aimed to assess the safety and efficacy of ambulatory treatment in patients with uncomplicated acute diverticulitis (AD) compared with inpatient treatment. Methods This is a retrospective comparative study conducted in two hospitals. All patients presented to the emergency department with CT-confirmed Hichney 1a AD during the period from 01/01/2022 to 31/12/2022 were included in this study. Patients with complicated diverticulitis or CT was not performed were excluded. All patients were followed for 12 months for re-admission and AD recurrence. Data analysis was performed with SPSS 27. Results A total of 137 patients were presented during the study period with CT-confirmed Hinchey 1a AD. The median age was 62 (24-94) years old, with a female-to-male ratio of 1.7:1. In the majority of patients (75.9%), WBCS was < 15 and CRP < 100. Moreover, 37.2% had previous AD, and it was complicated in 5.8%. For 12 months of follow-up, 19% of the cases developed diverticulitis recurrence. However, only 1 patient required surgery, and no patient required radiology intervention. No mortality was reported. A luminal investigation (CT colonoscopy or endoscopy) was organized in 61.3%, and colon cancer was detected in one patient. A comparison of patients who were treated as ambulatory (n=35) versus inpatient (n= 102) showed no significant difference regarding re-admission and recurrence of AD (P= 0.22) and surgical intervention (P=0.5) during 1-year follow-up. Conclusion With comparable results to inpatient treatment, the Ambulatory treatment of Hinchey 1a AD is safe and feasible and provides a reduction of treatment expenses.