This study was designed to assess the costs and outcomes of
colostomy and
colostomy reversal in patients with
diverticulitis and examine the impact of such procedures on the health care system.
METHODS: We employed a retrospective design and used a Washington State administrative database to identify patients undergoing operations with
colostomy (1987-2002) who were followed over time. Descriptive and comparative analysis was performed, focusing on patients with
diverticulitis.
RESULTS: There were 16,556 patients who underwent
colostomy and 5,420 (32.7 percent) were for
diverticulitis and its related complications (mean age, 64.8 +/- 15.1 years; 53.2 percent female). In patients with
diverticulitis, the rate of
colostomy reversal was 56.3 percent (80 percent in patients less than 50 years, and 30 percent in patients over 77 years). The in-hospital mortality rate after
colostomy reversal was 0.36 percent, and was 2.6 percent in those over 77 years of age. After
colostomy reversal a second stoma was used in 3.4 percent, reoperation was required for
bleeding complications in 0.6 percent, and infectious complications were noted in 2 percent. The length of time from
colostomy to its reversal was approximately five months (138.1 +/- 164 days; interquartile range, 72-156). The relationship between the length of time from
colostomy to reversal was evaluated and the adjusted odds of a second stoma being used at the time of
colostomy reversal were 45 percent higher (odds ratio, 1.45; 95 percent confidence interval, 1.22, 1.73) for each increase in time interval (<3, 6-9, 9-12, >12 months).
CONCLUSIONS: