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Seasonal Variation in Diverticulitis: Evidence From Both Hemispheres

Adler, Joel T. M.D., M.P.H.; Chang, David C. Ph.D., M.B.A., M.P.H.; Chan, Andrew T. M.D., M.P.H.; Faiz, Omar M.B.B.S., M.S.; Maguire, Lillias H. M.D.

doi: 10.1097/DCR.0000000000000657
Original Contributions: Benign

BACKGROUND: Diverticulitis is a common and morbid disease with incompletely understood risk factors and pathophysiology. Geographic and, recently, seasonal trends in diverticulitis have been described in the United States.

OBJECTIVE: The purpose of this study was to investigate and compare seasonal trends in urgent hospital admission for diverticulitis in geographically distinct populations in the northern and southern hemispheres.

DESIGN: Inpatient, urgent admissions for diverticulitis were identified within the Dr Foster Intelligence Global Comparators Dataset, a global benchmarking collaborative.

SETTINGS: Admissions to participating hospitals in the United Kingdom, Australia, and the United States were identified between 2008 and 2013.

PATIENTS: A total of 18,672 urgent admissions for diverticulitis were identified among 5.5-million admissions.

MAIN OUTCOME MEASURES: Four separate hypothesis testing methods were used to identify seasonal trends in diverticulitis admissions among international patient populations.

RESULTS: Seasonal trends were present in all 3 countries. A summer peak was observed in both hemispheres using multiple statistical testing methods. Logistic regression analyses identified summer months as significantly associated with diverticulitis admission in all 3 countries.

LIMITATIONS: This study is limited by restriction to inpatient admissions, reliance on administrative data, and participation of select hospitals within the database.

CONCLUSIONS: These data suggest a shared seasonal risk factor among geographically distinct populations for diverticulitis.

Supplemental Digital Content is available in the text.

1 Center for Surgery and Public Health at Brigham and Women’s Hospital, Boston, Massachusetts

2 Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts

3 Division of Gastroenterology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts

4 St Mark's Hospital, North West London NHS Trust, London, United Kingdom

5 Imperial College London, London, United Kingdom

Supplemental digital content is available for this article. Direct URL citations appear in the printed text, and links to the digital files are provided in the HTML and PDF versions of this article on the journal’s Web site (

Funding/Support: Dr Adler is funded by the Arthur Tracy Cabot Fellowship from the Center for Surgery and Public Health at Brigham and Women’s Hospital.

Financial Disclosure: None reported.

Correspondence: Lillias H. Maguire, M.D., Department of Surgery, Massachusetts General Hospital, 55 Fruit St, Boston, MA 02114. E-mail:

© 2016 The American Society of Colon and Rectal Surgeons