Acute diverticulitis in immunocompromised patients: evidence from an international multicenter observational registry (Web-based International Register of Emergency Surgery and Trauma, Wires-T)

• Published in: Techniques in coloproctology 2023-09, Vol.27 (9), p.747-757
• Main Authors: Tartaglia, Dario, Cremonini, Camilla, Annunziata, Elena, Catena, Fausto, Sartelli, Massimo, Kirkpatrick, Andrew W., Musetti, Serena, Strambi, Silvia, Chiarugi, Massimo, Coccolini, Federico
• Format: Article
• Language: English
• Subjects: Abdominal Surgery; Colorectal Surgery; Diverticulitis; Gastroenterology; Medicine; Medicine & Public Health; Mortality; Original; Original Article; Proctology; Sepsis; Surgery
• ISSN: 1123-6337; 1128-045X
• DOI: 10.1007/s10151-023-02758-6

Background Immunocompromised patients with acute diverticulitis are at increased risk of morbidity and mortality. The aim of this study was to compare clinical presentations, types of treatment, and outcomes between immunocompromised and immunocompetent patients with acute diverticulitis. Methods We compared the data of patients with acute diverticulitis extracted from the Web-based International Registry of Emergency Surgery and Trauma (WIRES-T) from January 2018 to December 2021. First, two groups were identified: medical therapy (A) and surgical therapy (B). Each group was divided into three subgroups: nonimmunocompromised (grade 0), mildly to moderately (grade 1), and severely immunocompromised (grade 2). Results Data from 482 patients were analyzed—229 patients (47.5%) [M:F = 1:1; median age: 60 (24–95) years] in group A and 253 patients (52.5%) [M:F = 1:1; median age: 71 (26–94) years] in group B. There was a significant difference between the two groups in grade distribution: 69.9% versus 38.3% for grade 0, 26.6% versus 51% for grade 1, and 3.5% versus 10.7% for grade 2 ( p   2 ( p  = 0.0002), and Mannheim Peritonitis Index ( p  = 0.010). A Hartmann’s procedure is mainly performed in grades 1–2 ( p