SP4.1.2 Management and Ambulation of Uncomplicated Acute Diverticulitis during the COVID-19 Pandemic – A Clinical Audit in a District General Hospital

Abstract

AimsTo audit the management (ambulation versus admission) of acute diverticulitis presenting to a London DGH.MethodsA retrospective clinical audit. Data on cases of acute diverticulitis presenting to the general surgical department at Ealing Hospital were collected over a period of 92 days. The medical notes were screened and the indication for admission in hospital was recorded. Each admission was then assessed for compliance with standard criteria for appropriate admission, derived from national guidelines by NICE. Patients admitted despite not meting these criteria were deemed as inappropriate admissions.ResultsmAll patient referrals to General Surgery at Ealing Hospital were screened from 1/7/21 to 30/9/21. 618 patients were identified. A total of 18 patients presented with radiologically-confirmed diverticulitis in this period (2.9%). Of these, 14 patients were admitted (77.8%). None of the patients ambulated met the criteria for admission. If the admitting teams were to adhere to National Guidelines, 15 of the 18 patients presented and 11 of the 14 patients admitted could have been safely ambulated. In inappropriately-admitted cases, none received surgical intervention. The mean number of days spent in hospital for inappropriate admissions was 3.27 (Range 1–8 days). This translates to 49 patient-days that could have been safely avoided according to national guidelines. The cost incurred by the NHS by the inappropriate admission of these patients is estimated at £78,400 p.a.ConclusionsSafe ambulation of patients presenting with acute uncomplicated diverticulitis can improve departmental efficacy, patient flow and ultimately reduce bed pressures and expenditure associated with hospital admissions.