Abstract
Background
This study had aimed to describe long-term decision regret, bowel dysfunction, and
the overall quality of life in patients with diverticulitis, and to determine if elective
colectomy was associated with these patient-reported outcome measures.
Methods
This mixed-methods, survey-based study was administered to a national cohort of patients
in the United States with diverticulitis. We measured decision regret (Brehaut Decision
Regret), bowel dysfunction (Low Anterior Resection Syndrome score), and the overall
quality of life (EuroQol 5 Dimension) in this population. We asked open-ended questions
to elucidate factors that influenced patients’ choices between elective colectomy
and observation.
Results
Among the 614 respondents, 294 (48%) chose between colectomy and observational management,
94 (15%) had surgery, and 157 (26%) had major Low Anterior Resection Syndrome. Of
the 294 that chose between colectomy and observational management, 51 (17%) experienced
decision regret. Colectomy was associated with an average decrease in the Brehaut
Decision Regret score by 6 points but was not associated with a categorical measure
of decision regret (Brehaut Score ≥50). Bowel dysfunction and overall quality of life
were not significantly associated with colectomy. Disease-related factors, psychosocial
factors, and interactions with physicians were commonly cited as reasons for pursuing
colectomy or observational management.
Conclusion
Patients with self-reported diverticulitis describe high levels of decision regret
and bowel dysfunction regardless of chosen management strategy. Physicians should
be aware that psychosocial factors can strongly influence a patient’s choice between
colectomy and observational management. We advocated for future prospective studies
using patient reported outcome metrics to improve outcomes in diverticulitis.
Graphical abstract
Graphical Abstract
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Article info
Publication history
Published online: August 01, 2022
Accepted:
April 29,
2022
Footnotes
Mr Harrison and Dr Ford have contributed equally to this project and share first authorship.
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
