Gabriele Ricci (Rome / IT), Stefano Manfroni (Rome / IT), Ennio Adami (Rome / IT), Davide Telesco (Rome / IT), Noemi Di Fuccia (Rome / IT), Pierluigi Marini (Rome / IT), Walter Elisei (Rome / IT), Roberto Faggiani (Rome / IT), Antonio Tursi (Rome / IT)
Abstract text (incl. references and figure legends)
Introduction:
Acute colonic diverticulitis (AD) is one of the most common clinical conditions encountered by surgeons and gastroenterologist in the acute setting. Although left-sided colonic diverticulosis remains more common among elderly patients, a dramatic rise of its incidence has been seen in younger age groups in recent years. There are several guidelines relating to the management of the disease but we don"t have data about the efficacy of diagnostic and therapeutic pathways in hospitals.
Material and Methods:
In San Camillo Hospital (Rome-Italy) a multidisciplinary panel of experts, coordinated by a central coordinator, was selected to create a diagnostic and therapeutic pathways (DTAP) able to optimization of care. Aims of the study was to evaluate the effectiveness of the DTAP in terms of reduction of hospitalization stay and clinical outcomes.
Results:
The use of the DTP began in 2021. During the first year 121 patients affected by Acute Diverticulitis (AD) were admitted in our department:
- 88 (72.7%) patients with AD without hemorrhage: 32 (36.4%) patients with Complicated AD (68.7% underwent surgical resection and 31.3% have been treated conservatively) and 56 (63.6%) patients with uncomplicated AD (17.8% were discharged and 81.8% were admitted to the ward)
-33 (27.3%) patients with AD with hemorrhage: 6 (18.2%) undervent surgical resection or selective embolization and 27 (81.8%) have been treated conservatively.
Comparing these data with a cohort of patients before the use of DTAP (2015-2019), we have seen less surgical resection or selective embolization (35.3% vs 18.2%) with a significant reduction of time spent in emergency room (55% vs 23.9% for stay > 24 hours)
Conclusions:
This new "diagnostic and therapeutic assistance pathways" (DTAP) is able to select patients who really need surgery and to reduce residence time in emergency room.
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