Family History is Associated with Recurrent Diverticulitis After an Episode of Diverticulitis Managed Nonoperatively.

BACKGROUND: To date, the impact of family history on diverticulitis outcomes has been poorly described. OBJECTIVE: To evaluate the association between family history and diverticulitis recurrence after an episode of diverticulitis managed nonoperatively. DESIGN: Retrospective cohort study with prospective telephone follow-up. SETTINGS: Two McGill University-affiliated tertiary care hospitals in Montreal, Canada. PATIENTS: All immunocompetent patients with CT-proven left-sided diverticulitis who were managed non-operatively from 2007-2017. INTERVENTION: A positive family history for diverticulitis, as assessed by a detailed telephone questionnaire. MAIN OUTCOME MEASURES: The primary outcome was diverticulitis recurrence occurring >60 days following the index episode. Secondary outcomes included a complicated recurrence and >1 recurrence (i.e., re-recurrence). RESULTS: Of the 879 patients identified in the database, 433 completed the telephone questionnaire (response rate: 48.9%). Among them, 173 (40.0%) had a positive family history of diverticulitis and 260 (60.0%) did not. Compared to patients with no family history, patients with family history had a younger median age (59.0 vs. 62.0 years, p=0.020) and higher incidence of abscess (24.3% vs. 3.5%, p 1 relative with a history of diverticulitis had a higher hazards of recurrence (HR: 2.93, 95% CI 1.96-4.39) compared to patients with only 1 relative. Positive family history was also associated with the development of a complicated recurrence (HR: 8.30, 95% CI 3.64-18.9) and >1 recurrence (HR: 2.03, 95% CI 1.13-3.65). LIMITATIONS: Potential for recall and non-response bias. CONCLUSION: Patients with a positive family history of diverticulitis are at higher risk for recurrent diverticulitis and complicated recurrences. See Video Abstract at http://links.lww.com/DCR/B215.