Obesity Increases Risk of Complications of Diverticular Disease in a Va Patient Population

Michelle K Savu, MD, G. Abourjaily, MD, A Logue, MD, J Mayoral, MD, Ej Ledesma, MD, W.b. Perry, MD, Kareem Eid, MD. South Texas VA HCS/University of Texas Health Science Center, San Antonio, TX

Objective: Obesity has been implicated in some research studies to affect the severity of the  presentation of diverticular disease. Our objective was to study the relationship between obesity and diverticular disease presentation and treatment in a VA patient population.
Methods: We performed a retrospective study using a computerized patient medical record database (CPRS) in the VA system based on CPT codes for diverticular disease and obesity for patients with the diagnosis between 2009-2010. Obesity was defined as a BMI >/= 30 kg/m2.
Results: Fifty five patients were admitted with the diagnosis of diverticulitis or diverticular disease during this timeframe. The average age of all patients was 67 (range 40-91) and the average BMI was 28.9 +/- 6 kg/m2. Forty four percent (24 / 55) of patients diagnosed with diverticular disease were obese. 10 patients had complications requiring surgical intervention (3 perforations, 4 colovesicle fistulas and 3 elective surgeries for recurrent diverticulitis). Of the patients requiring surgery 7 were obese. A significantly higher percentage of obese patients with diverticular disease [7/24(29%)] versus nonobese patients with diverticular disease [3/31(9.7%)] had complications requiring surgery (p<0.05). The average age and BMI of obese patients requiring surgery were significantly higher than the nonobese patients requiring surgery 61 +/- 3 years and 34.3 kg/m2 vs 73+/- 4 years and 24.5 kg/m2 respectively ( p<0.05)
Conclusions: Our data support that obese patients with diverticular disease have a significantly increased risk of developing complications requiring surgical intervention than nonobese patients with diverticular disease. In addition, these complications are more likely to occur at an earlier age. These data would support consideration of earlier elective surgical intervention for obese patients with presenting symptoms of diverticular disease.
 

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