Predictive risk model of recurrence of acute diverticulitis after the first episode
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10.1002/wjs.12045 |
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Título
Predictive risk model of recurrence of acute diverticulitis after the first episodeAutoría
Fecha de publicación
2023-12-01Editor
WileyISSN
0364-2313Cita bibliográfica
Pastor‐Mora, J. C., Fortea‐Sanchís, C., Coret‐Franco, A., García‐Martínez, J. A., Cosa‐Rodriguez, R., Nomdédeu‐Guinot, J., ... & Llueca, A. (2024). Predictive risk model of recurrence of acute diverticulitis after the first episode. World Journal of Surgery, 48(2), 466-473.Tipo de documento
info:eu-repo/semantics/articleVersión de la editorial
https://onlinelibrary.wiley.com/doi/full/10.1002/wjs.12045Versión
info:eu-repo/semantics/publishedVersionPalabras clave / Materias
Resumen
INTRODUCTION: The recurrence of acute diverticulitis (AD) of the colon is frequent and leads to hospital readmissions and the need for elective surgery in selected cases. It is important to individualize risk factors ... [+]
INTRODUCTION: The recurrence of acute diverticulitis (AD) of the colon is frequent and leads to hospital readmissions and the need for elective surgery in selected cases. It is important to individualize risk factors and develop predictive tools for their identification. MATERIALS AND METHODS: This prospective observational study included 368 patients who were diagnosed with AD between 2016 and 2021 in a tertiary general university hospital during their first episode and who had a good response to antibiotic, percutaneous, or peritoneal lavage treatment. Univariate and multivariate Cox regression analyses of the variables associated with recurrence were performed. Subsequently, a predictive risk score was developed and validated through survival studies. RESULTS: After a median follow-up of 50 months, there were 71 (19.3%) cases of recurrence out of a total of 368 patients. The mean time of recurrence was 15 months, and 73.3% of cases of recurrence occurred before 2 years of follow-up. Recurrence was independently associated with presentation with colonic perforation in the antimesenteric location (HR 3.67 95% CI [1.59-8.4]) and a CRP level greater than 100 mg/dl (HR 1.69 95% CI [1.04-2.77). A score with 5 variables was created that differentiated two risk groups: intermediate risk (0-3 points), with 19% recurrence and high risk (more than 3 points), with 42% recurrence. CONCLUSIONS: The risk of recurrence after the first episode of diverticulitis can be estimated using predictive scores. The detection of high-risk patients facilitates the individualization of follow-up and treatment. [-]
Publicado en
World Journal of Surgery, 2024, vol. 48, no 2.Derechos de acceso
© 2023 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC).
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http://rightsstatements.org/vocab/InC/1.0/
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