Disparities influencing rates of urgent/emergent surgery for diverticulitis in the state of Florida

Riccardo Lemini, Aaron C. Spaulding, Osayande Osagiede, Jordan J. Cochuyt, James M. Naessens, Marie Crandall, Robert R. Cima, Dorin T. Colibaseanu

Research output: Contribution to journalArticle

Abstract

Background: Patients with diverticulitis have a 20% risk of requiring urgent/emergent treatment. Since morbidity and mortality rates differ between elective and urgent/emergent care, understanding associated disparities is critical. We compared factors associated with treatment setting for diverticulitis and evaluated disparities regarding access to Minimally Invasive Surgery (MIS) and development of complications. Methods: The Florida Inpatient Discharge Dataset was queried for patients diagnosed with diverticulitis. Three multivariate models were utilized: 1) elective vs urgent/emergent surgery, 2) MIS vs open and 3) presence of complications. Results: The analysis included 12,654 patients. Factors associated with increased odds of urgent/emergent care included being uninsured or covered by Medicaid, African American, obese, or more comorbid. MIS was associated with reduced odds of complications. Patients treated by high-volume or colorectal surgeons had increased odds of receiving MIS. Conclusions: Patients were more likely to receive MIS if they were treated by a colorectal surgeon, or a high-volume surgeon (colorectal, or general surgeon). Additionally, patients that were older, had increased comorbidities, or did not have health insurance were less likely to receive MIS.

Original languageEnglish (US)
Pages (from-to)1012-1018
Number of pages7
JournalAmerican journal of surgery
Volume219
Issue number6
DOIs
StatePublished - Jun 2020

Keywords

  • Colorectal surgery
  • Complicated diverticulitis
  • Disparities
  • Minimally invasive surgery

ASJC Scopus subject areas

  • Surgery

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  • Cite this

    Lemini, R., Spaulding, A. C., Osagiede, O., Cochuyt, J. J., Naessens, J. M., Crandall, M., Cima, R. R., & Colibaseanu, D. T. (2020). Disparities influencing rates of urgent/emergent surgery for diverticulitis in the state of Florida. American journal of surgery, 219(6), 1012-1018. https://doi.org/10.1016/j.amjsurg.2019.09.005