Outpatient Management Protocol for Uncomplicated Diverticulitis : A 3-Year Monocentric Experience in a Tertiary Hospital

Article Article scientifique Article Outpatient Management Protocol for Uncomplicated Diverticulitis : A 3-Year Monocentric Experience in a Tertiary Hospital eng 2024-10-04 2024-10-04 author Burgard Marie Division of Digestive Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland. 426447 author Litchinko Alexis 0000-0002-1246-756X Division of Digestive Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland.,Department of Surgery, Cantonal Hospital of Fribourg Chemin des Pensionnats 2/6, 1752 Villars-sur-Glâne, Switzerland. 405945 author Meyer Jérémy 0000-0003-3381-9146 Division of Digestive Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland. 583453 Département de chirurgie (CHIRU) author Toso Christian 0000-0003-1652-4522 Division of Digestive Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland.,Transplantation and Hepatology Laboratory, Geneva Medical University, Rue Michel Servet 1, 1206 Geneva, Switzerland. 92271 Département de chirurgie (CHIRU) author Ris Frédéric 0000-0001-7421-6101 Division of Digestive Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland. 53083 Département de chirurgie (CHIRU) author Delaune Vaihere 0000-0001-8931-0977 Division of Digestive Surgery, Geneva University Hospitals, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland.,Transplantation and Hepatology Laboratory, Geneva Medical University, Rue Michel Servet 1, 1206 Geneva, Switzerland. 839496 5920 10.3390/jcm13195920 39407980 2077-0383 PMC11477958 https://www.mdpi.com/2077-0383/13/19/5920 Background/Objectives: The management of acute uncomplicated diverticulitis (AUD) has shifted towards outpatient care in the last decade, challenging the traditional inpatient approach. We aimed to analyze the safety and feasibility of a structured outpatient treatment pathway for AUD in a tertiary hospital. Methods: We conducted a retrospective observational cohort analysis of patients who underwent outpatient management for AUD at the Geneva University Hospitals from 2019 to 2021. Patient demographics, selection criteria, treatment protocols, and outcomes were analyzed. Results: Two-hundred and twenty patients were included in the outpatient cohort. Four patients (1.8%) required hospitalization due to the failure of outpatient management, whereas the majority of patients (116 patients, 98.2%) experienced a successful resolution of their symptoms without hospitalization. In a univariate analysis, factors associated with treatment failure included elevated white blood cell counts at admission (14 G/l vs. 10.6 G/l, p = 0.049) and the first follow-up appointment, (10.7 G/l vs. 7.4 G/l, p = 0.011) and the presence of free air on their CT scan (25% vs. 2,3%, p = 0.033). In a multivariate analysis, the presence of free air was the only identified risk factor for unsuccessful outpatient management (p = 0.05). We observed high rates of follow-up compliance (99.1%). Conclusion: Under the condition of a warranted outpatient follow-up appointment and with adequate selection criteria, outpatient management appears to be an effective approach for most patients with AUD, emphasizing the importance of tailored therapeutic interventions and vigilant clinical assessments for optimal outcomes. Outpatient management Treatment protocol Uncomplicated diverticulitis Dewey 617 57 Département de chirurgie 222 false 1329 Chirurgie viscérale (HUG) 562 Transplantation et hépatologie 905 Journal of clinical medicine 13 19 a297f867-440a-4cff-b0b4-82ba48f52c35 Article (Published version) Public jcm-13-05920.pdf 677000 application/pdf CC BY-4.0 a09d6c0756e14749d47285829885c48443303c4561d02605a182a68e1135589f openAccess Faculté de médecine / Section de médecine clinique / Département de chirurgie

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Outpatient Management Protocol for Uncomplicated Diverticulitis : A 3-Year Monocentric Experience in a Tertiary Hospital	Journal of clinical medicine			2024	10	314

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Burgard, Marie