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. 2016 Sep;29(3):258-63.
doi: 10.1055/s-0036-1584503.

Epidemiologic Analysis of Diverticulitis

Marie D Jena  1 , Peter W Marcello  1 , Patricia L Roberts  1 , Thomas E Read  1 , David J Schoetz  1 , Jason F Hall  1 , Todd Francone  1 , Rocco Ricciardi  1
Affiliations

Epidemiologic Analysis of Diverticulitis

Marie D Jena et al. Clin Colon Rectal Surg. 2016 Sep.

Abstract

The aim of this article is to evaluate geographic variation in the incidence of diverticulitis and examine behavioral and environmental factors associated with high rates of diverticulitis across the United States. We used state hospital discharge data from 20 states to determine rates of inpatient diverticulitis from January 2002 to December 2004 at patient's county of residence. Next, we merged the county level data with behavioral and environmental survey data from the Behavioral Risk Factor Surveillance System (BRFSS). Finally, we determined the association between behavioral and environmental factors (i.e., teeth removal, dental cleaning, air quality, smoking, alcohol, vaccine, vitamins, and mental health) and high rates of diverticulitis. From January 1, 2002, to December 31, 2004, a total of 345,216 hospitalizations for acute diverticulitis were recorded for 1,055 counties. We identified rates of diverticulitis that ranged from 35.4 to 332.7 per 100,000 population. On univariate analysis, high diverticulitis burden was associated with regions of the country with substantial tooth loss from dental disease (45.8% for high diverticulitis counties vs. 37.5% for low diverticulitis counties; p = 0.0001). There is considerable variability in diverticulitis cases by county of residence across the nation. Potential triggers of diverticulitis may be associated with tooth removal and sun exposure.

Keywords: BRFSS; CDC; diverticulitis; epidemiology; population; seasonal variation.

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Conflict of interest statement

Disclosures None. Contributions All authors were responsible for drafting of the manuscript, analysis and interpretation of data, and critical revision of the manuscript for important intellectual content. R.R. had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. The study has been approved by all authors in the present format.

Figures

Fig. 1
Fig. 1
Mean annual rate of diverticulitis per 100,000 population in 20 states by county. Each circle represents the mean rate of diverticulitis from 2002 to 2004 in each county for which we have state hospital discharge data from the Agency for Healthcare Research and Quality and the Office of Statewide Health Planning and Development in California. Note that we only included data for 2003 and 2004 for the state of Utah.
See this image and copyright information in PMC

References

    1. Parks T G. Natural history of diverticular disease of the colon. Clin Gastroenterol. 1975;4(1):53–69. - PubMed
    1. Ricciardi R, Baxter N N, Read T E, Marcello P W, Hall J, Roberts P L. Is the decline in the surgical treatment for diverticulitis associated with an increase in complicated diverticulitis? Dis Colon Rectum. 2009;52(9):1558–1563. - PubMed
    1. Etzioni D A, Mack T M, Beart R W Jr, Kaiser A M. Diverticulitis in the United States: 1998-2005: changing patterns of disease and treatment. Ann Surg. 2009;249(2):210–217. - PubMed
    1. Aldoori W H, Giovannucci E L, Rockett H R, Sampson L, Rimm E B, Willett W C. A prospective study of dietary fiber types and symptomatic diverticular disease in men. J Nutr. 1998;128(4):714–719. - PubMed
    1. Miura S, Kodaira S, Shatari T, Nishioka M, Hosoda Y, Hisa T K. Recent trends in diverticulosis of the right colon in Japan: retrospective review in a regional hospital. Dis Colon Rectum. 2000;43(10):1383–1389. - PubMed