TY - JOUR
T1 - Smoking is associated with an increased risk for surgery in diverticulitis
T2 - A case control study
AU - Diamant, Michael J.
AU - Schaffer, Samuel
AU - Coward, Stephanie
AU - Kuenzig, M. Ellen
AU - Hubbard, James
AU - Eksteen, Bertus
AU - Heitman, Steven
AU - Panaccione, Remo
AU - Ghosh, Subrata
AU - Kaplan, Gilaad G.
N1 - Publisher Copyright:
© 2016 Diamant et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2016/7
Y1 - 2016/7
N2 - 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.
AB - 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.
UR - https://www.scopus.com/pages/publications/84982732895
U2 - 10.1371/journal.pone.0153871
DO - 10.1371/journal.pone.0153871
M3 - Article
C2 - 27467077
AN - SCOPUS:84982732895
SN - 1932-6203
VL - 11
JO - PLOS ONE
JF - PLOS ONE
IS - 7
M1 - e0153871
ER -