Gut Liver.  2013 Jul;7(4):443-449.

Risk Factors for Severe Diverticulitis in Computed Tomography-Confirmed Acute Diverticulitis in Korea

• Park NS
• Jeen YT
• Choi HS
• Kim ES
• Kim YJ
• Keum B
• Seo YS
• Chun HJ
• Lee HS
• Um SH
• Kim CD
• Ryu HS

Abstract

BACKGROUND/AIMS
Acute complicated diverticulitis can be subdivided into moderate diverticulitis and severe diverticulitis. Although there have been numerous studies on the risk factors for complicated diverticulitis, little research has focused on severe diverticulitis. This study was designed to identify the risk factors for severe diverticulitis in an acute diverticulitis attack using the modified Hinchey classification.
METHODS
Patients were included if they had any evidence of acute diverticulitis detected by computed tomography. The patients were subdivided into severe diverticulitis (Hinchey class > or =Ib; abscesses or peritonitis) and moderate diverticulitis (Hinchey class Ia; pericolic inflammation) groups.
RESULTS
Of the 128 patients, 25 exhibited severe diverticulitis, and 103 exhibited moderate diverticulitis. In a multivariate analysis, age >50 years (odds ratio [OR], 5.27; p=0.017), smoking (OR, 3.61; p=0.044), comorbidity (OR, 4.98; p=0.045), leukocytosis (OR, 7.70; p=0.003), recurrence (OR, 4.95; p=0.032), and left-sided diverticulitis (OR, 6.92; p=0.006) were significantly associated with severe diverticulitis.
CONCLUSIONS
This study suggests that the risk factors for severe diverticulitis are age >50 years, smoking, comorbidity, leukocytosis, recurrent episodes, and left-sided diverticulitis.

Keyword

Diverticulitis; Severity; Computed tomography; Hinchey classification

MeSH Terms

Abscess
Comorbidity
Diverticulitis
Humans
Korea
Leukocytosis
Multivariate Analysis
Recurrence
Risk Factors
Smoke
Smoking
Smoke