{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T13:20:38Z","timestamp":1789132838590,"version":"build-2803163510"},"reference-count":28,"publisher":"BMJ","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Gut"],"accepted":{"date-parts":[[2011,3,29]]},"published-print":{"date-parts":[[2012,1]]},"abstract":"\n Objective<\/jats:title>\n To determine the risk of developing complicated colonic diverticular disease (CCDD) with prior episodes of acute diverticulitis and determine the mortality of the spectrum of CCDD.<\/jats:p>\n <\/jats:sec>\n \n Design<\/jats:title>\n Population-based cohort study.<\/jats:p>\n <\/jats:sec>\n \n Setting<\/jats:title>\n Computerised records from the General Practice Research Database linked to Hospital Episode Statistics data from the UK.<\/jats:p>\n <\/jats:sec>\n \n Participants<\/jats:title>\n Patients and controls registered in the General Practice Research Database from 1990 to 2007.<\/jats:p>\n <\/jats:sec>\n \n Main outcome measures<\/jats:title>\n Mortality was calculated and Cox regression modelling used to provide adjusted HRs and 95% CI. Logistic regression was used to model the effect of prior acute diverticulitis on the development of complications.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 2950 patients (1872 (63.5%) female) had a diagnosis of CCDD (8739 controls). A total of 1042 (35.3%) patients died compared with 2062 (23.6%) controls. Most excess deaths occurred in the first year after the complication. Patients with a perforation\/abscess had a 4.5-fold increase in 1-year mortality (HR 4.55, 95% CI 3.74 to 5.52) compared with the general population, whereas those with a fistula or stricture had a 2.5-fold increase in mortality (fistula HR 2.60, 95% CI 1.47 to 4.62; stricture HR 2.41, 95% CI 1.86 to 3.11). Although most patients (2133 (72.3%)) had suffered no prior episodes of acute diverticulitis, increasing episodes of acute diverticulitis were associated with an increased risk of developing a fistula (two or more prior episodes, OR 1.54 95%, CI 1.08 to 2.19), but there was no clear relationship with stricture or perforation\/abscess.<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Although most patients have experienced no prior episodes of acute diverticulitis, fistula formation is preceded by bouts of inflammation. Excess 1-year mortality across the spectrum of CCDD compared with the general population is substantial.<\/jats:p>\n <\/jats:sec>","DOI":"10.1136\/gut.2011.238808","type":"journal-article","created":{"date-parts":[[2011,5,6]],"date-time":"2011-05-06T23:59:25Z","timestamp":1304726365000},"page":"95-100","source":"Crossref","is-referenced-by-count":63,"title":["Role of acute diverticulitis in the development of complicated colonic diverticular disease and 1-year mortality after diagnosis in the UK: population-based cohort study"],"prefix":"10.1136","volume":"61","author":[{"given":"David J","family":"Humes","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"West","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2011,5,6]]},"reference":[{"key":"2025120523371936000_61.1.95.1","doi-asserted-by":"crossref","first-page":"53","DOI":"10.1016\/S0300-5089(21)00097-3","article-title":"Natural history of diverticular disease of the colon","volume":"4","author":"Parks","year":"1975","journal-title":"Clin 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