A comparison of diverticulitis in Crohn's disease versus ulcerative colitis

BACKGROUND AND AIM: Inflammatory bowel disease (IBD) and diverticulitis both increase morbidity, especially when associated with in‐patient hospitalization. This study aimed to evaluate whether hospitalization burden differs for diverticulitis in patients with a history of Crohn's disease (CD) compared to ulcerative colitis (UC). METHOD: All patients hospitalized for acute diverticulitis with pre‐existing UC or CD in 2014 were selected using the national in‐patient sample. Cases were identified using the International Classification of Diseases, Ninth Edition codes. Primary outcomes were mortality, cost of admission, length of stay (LOS), and colectomy. RESULTS: A total of 1815 patients were admitted with diverticulitis, and those with CD had a hospitalization associated with decreased cost (aOR −14 537, 95% CI −27 316 to −1758; P = 0.026) and LOS (aOR −1.31, 95% CI −2.41 to −0.208; P = 0.02) compared to UC. A second analysis comparing diverticulitis hospitalization between those with CD and those with the absence of IBD showed no significant difference in mortality (aOR 2.47, 95% CI 0.59 to 10.36; P = 0.22), LOS (aOR 0.03, 95% CI −0.47 to 0.54; P = 0.92), or cost of admission (aOR −2196, 95% CI −6933 to 2539; P = 0.36) between the cohorts. CONCLUSION: Patients with UC have worsened hospitalization outcomes when being treated for diverticulitis compared to CD. While the findings may be a result of a difference in colectomy rates, the etiology may also be multifactorial. These conclusions have not been previously described, and further investigations would better characterize these associations.