Smoking Is Associated with an Increased Risk for Surgery in Diverticulitis: A Case Control Study

Michael J Diamant, Samuel Schaffer, Stephanie Coward, M Ellen Kuenzig, James Hubbard, Bertus Eksteen, Steven Heitman, Remo Panaccione, Subrata Ghosh and Gilaad G Kaplan

PLOS ONE, 2016, vol. 11, issue 7, 1-8

Abstract: Importance: Cigarette smoking increases the risk of surgery in Crohn’s disease. However, the effect of smoking on the need for surgery for diverticulitis is unknown. Objective: We evaluated whether smoking was a risk factor for surgery among patients admitted to hospital with acute diverticulitis. Design: We conducted a population-based comparative cohort study of patients admitted to hospital for diverticulitis who were treated with medical versus surgical management. Setting & Participants: We used the population-based Discharge Abstract Database to identify 176 adults admitted emergently with a diagnosis of diverticulitis between 2009 and 2010 in Calgary. Intervention & Main Outcome: We performed a medical chart review to confirm the diagnosis of diverticulitis and to extract clinical data. The primary outcome was a partial colectomy during hospitalization. Logistic regression evaluated the association between smoking and surgery after adjusting for potential confounders, including age, sex, comorbidity, and disease severity. Results: A partial colectomy was performed on 35.6% of patients with diverticulitis and 1.3% died. Among diverticulitis patients, 26.8% were current smokers, 31.5% were ex-smokers, and 41.6% never smoked. Compared to non-smokers, current smokers (adjusted odds ratio [OR] 9.02; 95% confidence interval [CI]: 2.47–32.97) and former smokers (adjusted OR 5.41; 95% CI: 1.54–18.96) had increased odds of surgery. Conclusion and Relevance: Smoking is associated with the need for surgical management of diverticulitis.

Date: 2016
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0153871

DOI: 10.1371/journal.pone.0153871

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