Hospital in the home‐based management of acute diverticulitis: a safe and effective alternative to inpatient care. Issue 10 (27th April 2021)

• Record Type: Journal Article
• Authors: Hamilton, Jordan; Crosthwaite, Gary; Montalto, Michael
• Is Part Of: ANZ journal of surgery. Volume 91:Issue 10(2021)
• Page Start: 2106
• Page End: 2109
• Publication Date: 2021-04-27
• Subjects: diverticulitis -- hospital in the home -- outpatient management; Surgery -- Periodicals; 617.005
• DOI: 10.1111/ans.16901
• Languages: English
• ISSNs: 1445-1433

Abstract

Abstract: Background: The traditional approach to management of acute uncomplicated diverticulitis involves admission to hospital, antibiotic therapy, gut rest and monitoring for the development of complications. Despite evidence to suggest this can safely be performed in an outpatient setting, inpatient care remains standard practice in Australia potentially due to a variety of factors (van Dijk et al. 2018; Cirocchi et al. 2019). Hospital in the home (HIH) allows patients requiring complex care including intravenous antibiotics, intravenous fluids and complex pain relief to be managed at home. This study examined the safety and efficacy of HIH‐based care for acute diverticulitis over a 16‐year period. Methodology: A retrospective review of cases of acute diverticulitis managed under our HIH service from the period of 1st of January 2004 to 20th of October 2020 was completed. Baseline descriptive data relating to age, co‐morbidities and severity of diverticulitis was collected. Details of medical treatment provided and subsequent complications were also collected. Results: During the study period, 23 patients with acute diverticulitis were treated under the HIH unit. Among the study population, the median age was 60 (interquartile range 15) with a slight female predominance ( n = 13, 56.5%). This represented the first presentation in 60.9% of patients. Average length of stay was 3.6 days (SD = 1.0) with no acute complications recorded in the study period. Two patients (8.7%) had further episodes of acute diverticulitis within 60 days. Conclusion: In this study, the lack of complications demonstrated indicates that HIH‐based management of acute diverticulitis may be a viable and safe alternative to inpatient care. Abstract : Mild to moderate acute diverticulitis may safely be managed at home. Involvement of a hospital in the home (HIH) service may allow more complex care to be delivered at home for such patients. We conducted a review of acute diverticulitis cases managed under an HIH service at a large tertiary centre including patient demographics, treatment received and complications.