Uncomplicated Acute Diverticulitis: Identifying Risk Factors for Severe Outcomes

Uncomplicated Acute Diverticulitis: Identifying Risk Factors for Severe Outcomes Background The management of uncomplicated (Modified Hinchey Classification Ia) acute diverticulitis (AD) has become increasingly conservative, with a focus on symptomatic relief and supportive management. Clear criteria for patient selection are required to implement this safely. This retrospective study aimed to identify risk factors for severe clinical course in patients with uncomplicated AD. Materials and methods Patients admitted to General Surgery at two New Zealand tertiary centres over a period of 18 months were included. Univariate and multivariate analyses were carried out in order to identify factors associated with a more severe clinical course. This was defined by three endpoints: need for procedural intervention, admission [7 days and 30-day readmission; these were analysed separately and as a combined outcome. Results Uncomplicated AD was identified in 319 patients. Fifteen patients (5%) required procedural intervention; this was associated with SIRS (OR 3.92). Twenty-two (6.9%) patients were admitted for[7 days; this was associated with patient-reported pain score[8/10 (OR 5.67). Thirty-one patients (9.8%) required readmission within 30 days; this was associated with pain score[8/10 (OR 6.08) and first episode of AD (OR 2.47). Overall, 49 patients had a severe clinical course, and associated factors were regular steroid/immunomodulator use (OR 4.34), pain score[8/10 (OR http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png World Journal of Surgery Springer Journals

Uncomplicated Acute Diverticulitis: Identifying Risk Factors for Severe Outcomes

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Publisher
Springer International Publishing
Copyright
Copyright © 2017 by Société Internationale de Chirurgie
Subject
Medicine & Public Health; Surgery; Abdominal Surgery; Cardiac Surgery; General Surgery; Thoracic Surgery; Vascular Surgery
ISSN
0364-2313
eISSN
1432-2323
D.O.I.
10.1007/s00268-017-4012-9
Publisher site
See Article on Publisher Site

Abstract

Background The management of uncomplicated (Modified Hinchey Classification Ia) acute diverticulitis (AD) has become increasingly conservative, with a focus on symptomatic relief and supportive management. Clear criteria for patient selection are required to implement this safely. This retrospective study aimed to identify risk factors for severe clinical course in patients with uncomplicated AD. Materials and methods Patients admitted to General Surgery at two New Zealand tertiary centres over a period of 18 months were included. Univariate and multivariate analyses were carried out in order to identify factors associated with a more severe clinical course. This was defined by three endpoints: need for procedural intervention, admission [7 days and 30-day readmission; these were analysed separately and as a combined outcome. Results Uncomplicated AD was identified in 319 patients. Fifteen patients (5%) required procedural intervention; this was associated with SIRS (OR 3.92). Twenty-two (6.9%) patients were admitted for[7 days; this was associated with patient-reported pain score[8/10 (OR 5.67). Thirty-one patients (9.8%) required readmission within 30 days; this was associated with pain score[8/10 (OR 6.08) and first episode of AD (OR 2.47). Overall, 49 patients had a severe clinical course, and associated factors were regular steroid/immunomodulator use (OR 4.34), pain score[8/10 (OR

Journal

World Journal of SurgerySpringer Journals

Published: Apr 11, 2017

References

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