Ann Coloproctol.  2018 Feb;34(1):23-28. 10.3393/ac.2018.34.1.23.

Predictive Factors Affecting the Clinical Course of Patients With Diverticulitis: Who Needs Hospital Management?

• Yoo T
• Yang KH
• Kim J
• Park I
• Cho H
• Gwak G
• Bae BN
• Kim KH

• KMID: 2405555
• DOI: http://doi.org/10.3393/ac.2018.34.1.23

Abstract

PURPOSE
The aim of this study is to determine the predictable factors that affect the clinical course, especially the hospital stay, the operation performed, and to determine factors that will be helpful in deciding whether in-hospital or outpatient treatment is appropriate.
METHODS
We retrospectively collected medical data for patients who had been diagnosed with acute diverticulitis at Inje University Sanggye Paik Hospital between January and December 2016. In total, 117 patients were enrolled in this study. We examined clinical factors, including age, sex, body mass index, pain, body temperature, white blood cell count, C-reactive protein, nil per os (NPO) time, hospital duration, computed tomography (CT) findings, location of diverticulitis, operation performed, and presence of comorbidity (e.g., hypertension and diabetes mellitus).
RESULTS
In the multivariate analysis, the statistically significant factor related with hospital duration was the presence of perforation on the CT scan (P < 0.001). Longer NPO time was related with pain score (>7) (P = 0.011). Operations were mainly performed in patients with left-sided colonic diverticulitis (P = 0.012).
CONCLUSION
We suggest a perforation finding on the CT scan, a severe pain score at least above 7 on a numeric rating pain scale, and a left-sided lesion are absolute indications for in-hospital management.

Keyword

Diverticulitis; Predictive factors

MeSH Terms

Body Mass Index
Body Temperature
C-Reactive Protein
Comorbidity
Diverticulitis*
Diverticulitis, Colonic
Humans
Hypertension
Length of Stay
Leukocyte Count
Multivariate Analysis
Outpatients
Retrospective Studies
Tomography, X-Ray Computed
C-Reactive Protein