Development and Validation of Predictive Assessment of Complicated Diverticulitis Score
| Autor: | Valerio Papa, Lorenzo Maria Vetrone, Antonio Tursi, Francesco Franceschi, Loris Riccardo Lopetuso, Antonio Gasbarrini, Alfredo Papa, Marcello Covino, Gianludovico Rapaccini, Benedetta Simeoni |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Multivariate analysis medicine.drug_class Settore MED/12 - GASTROENTEROLOGIA Perforation (oil well) abscess Medicine (miscellaneous) Proton-pump inhibitor lcsh:Medicine Article complicated diverticulitis surgery 03 medical and health sciences 0302 clinical medicine diverticular hemorrhage Internal medicine medicine perforation Receiver operating characteristic business.industry lcsh:R Retrospective cohort study Emergency department Diverticulitis medicine.disease prognostic score acute diverticulitis 030220 oncology & carcinogenesis Cohort 030211 gastroenterology & hepatology business |
| Zdroj: | Journal of Personalized Medicine Volume 11 Issue 2 Journal of Personalized Medicine, Vol 11, Iss 80, p 80 (2021) |
| ISSN: | 2075-4426 |
| DOI: | 10.3390/jpm11020080 |
| Popis: | The prevalence of acute diverticulitis (AD) has progressively increased in recent decades, with correspondingly greater morbidity and mortality. The aim of the study is to develop a predictive score to identify patients with the highest risk of complicated AD. The clinical records of 1089 patients referred to the emergency department (ED) over a five-year period were reviewed. In multivariate analysis, male sex (p < 0.001), constipation (p = 0.002), hemoglobin < 11.9 g/dL (p < 0.001), C reactive protein > 80 mg/L (p < 0.001), severe obesity (p = 0.049), and no proton pump inhibitor treatment (p = 0.003) were independently associated with complicated AD. The predictive assessment of complicated (PACO)-diverticulitis (D) score, including these six variables, was applied to the retrospective cohort and then validated prospectively in a cohort including 282 patients. It categorized patients into three risk classes for complicated AD. The PACO-D score showed fair discrimination for complicated AD with an area under the receiver operating characteristic curve of 0.674 and 0.648, in the retrospective and prospective cohorts, respectively. The PACO-D score could be a practical clinical tool to identify patients at highest risk for complicated AD referred to the ED so that appropriate diagnostic and therapeutic resources could be appropriately allocated. Further external validation is needed to confirm these results. |
| Databáze: | OpenAIRE |
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