AB154. SOH26AB_0350. Frailty as a predictor of mortality in diverticulitis: a systematic review and meta-analysis

Background: Diverticulitis is a common surgical presentation, often requiring hospital admission. While frailty is recognised as an independent risk factor for mortality in surgical patients, its impact on mortality in diverticulitis has not been demonstrated by meta-analysis.

Methods: A systematic review was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, with a literature search undertaken of five scientific databases, with selection criteria specifying studies that compared mortality outcomes in diverticulitis based on frailty. Screening, data extraction, risk of bias assessment, and data analysis were undertaken independently by two reviewers. Meta-analysis of the earliest measure of mortality in each paper was undertaken using random-effects models to calculate a pooled unadjusted odds ratio (OR).

Results: Five studies met the inclusion criteria, with four studies comprising 82,200 patients providing event data suitable for quantitative synthesis. Meta-analysis demonstrated a significant association between frailty and mortality, with OR =4.73 [95% confidence interval (CI): 2.44–9.18; P<0.001; I²=92%], indicating that frail patients admitted with diverticulitis are at a substantially increased risk of death compared to non-frail patients.

Conclusions: Frailty is associated with more than a fourfold increase in mortality in patients admitted to hospital with diverticulitis. High statistical heterogeneity reflects the diverse populations and frailty measures in the included papers and does not reduce confidence in the direction of the observed effect. Routine frailty assessments in diverticulitis may help identify high-risk patients.

Keywords: Diverticulitis; frailty; mortality; meta-analysis; systematic review