TY  - JOUR
TI  - Factors predicting severity level, progression and
recurrence risk of acute left colonic diverticulitis
in Turkey: A multicenter study
AB  - BACKGROUND: Acute left colonic diverticulitis (ALCD) ranges from localized diverticulitis to perforation and fecal peritonitis,
and treatment varies from conservative management to emergency surgery. The risk factors for recurrence following nonoperative
management of ALCD is still controversial. We aimed to define the factors predicting severity level, progression and recurrence risk
of ALCD to timely select patients requiring surgery.
METHODS: This is a multicenter study where patients were included on accrual. Patients in our clinic between December 2017
and June 2019 with ALCD above 18 years of age were included (n=144) in this study, while 18 years and younger, pregnant or nursing mothers, those with Crohn’s disease, ulcerative colitis, colorectal and/or anal cancer were excluded from this study. Laboratory
parameters, Modified Hinchey Scores, clinical features, demographics, diet, smoking, alcohol consumption, body mass index, previous
diverticulitis episodes, chronic diseases of patients with ALCD, as well as recurrences within 18 months after discharge were evaluated.
RESULTS: The findings showed that smoking was more common in patients with previous episodes (p=0.04) and patients who
underwent emergency surgery (p=0.04). Recurrence was higher in Modified Hinchey 1b and 2 (p=0.03) than 0 and 1a. Patients who
were older than 50y had a higher propensity to undergo emergency surgery than the patients younger than 50y (p=0.049). Nausea,
fever, respiratory rate, procalcitonin, total bilirubin and direct bilirubin levels were higher in patients with Modified Hinchey 4 (p=0.03,
0.049, 0.02, 0.001, 0.002, 0.001, respectively). Recurrence was higher in patients with a smoking history, previous ALCD episodes,
lower body mass index and pandiverticulitis.
CONCLUSION: Laboratory parameters, body mass index, age, clinical features, previous episodes of diverticulitis and smoking may
predict the severity and progression of ALCD. Smoking and having low BMI seem to be precursors of ALCD recurrence, especially
when the patient with MHS 1b or 2 had at least one previous episode of ALCD. Control colonoscopy results are predictive of recurrence.
AU  - Ertekin, Cemalettin
AU  - ÖKMEN, HASAN
AU  - OZPEK, ADNAN
AU  - ATALAY, SÜLEYMAN
AU  - Sagiroglu, Julide
AU  - Beyazadam, Damla
AU  - Kurt, Yavuz
AU  - BAS, GÜRHAN
AU  - GOK, ALI FUAT KAAN
AU  - Aren, Acar
AU  - Ankarali, Handan
AU  - Ekinci, Ozgür
DO  - 10.14744/tjtes.2020.81839
PY  - 2021
JO  - Ulusal Travma ve Acil Cerrahi Dergisi
VL  - 27
IS  - 1
SN  - 1306-696X
SP  - 132
EP  - 138
DB  - TRDizin
UR  - http://search/yayin/detay/517006
ER  -