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Article

Development and Validation of Predictive Assessment of Complicated Diverticulitis Score

1
Emergency Medicine, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
2
Facoltà di Medicina e Chirurgia, Università Cattolica del S. Cuore, L.go A. Gemelli 8, 00168 Rome, Italy
3
Digestive Surgery, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
4
Territorial Gastroenterology Service, Azienda Sanitaria Locale Barletta-Andria-Trani, 70031 Andria, Italy
5
Department of Medicine and Ageing Sciences, G. d’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy
6
Center for Advanced Studies and Technology (CAST), G. d’Annunzio University of Chieti-Pescara, 66100 Chieti, Italy
7
Internal Medicine and Gastroenterology, Fondazione Policlinico Universitario A. Gemelli, IRCCS, 00168 Rome, Italy
*
Author to whom correspondence should be addressed.
Academic Editor: Alfredo Cesario
J. Pers. Med. 2021, 11(2), 80; https://doi.org/10.3390/jpm11020080
Received: 25 November 2020 / Revised: 19 January 2021 / Accepted: 27 January 2021 / Published: 29 January 2021
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. View Full-Text
Keywords: acute diverticulitis; complicated diverticulitis; prognostic score; surgery; abscess; perforation; diverticular hemorrhage acute diverticulitis; complicated diverticulitis; prognostic score; surgery; abscess; perforation; diverticular hemorrhage
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MDPI and ACS Style

Covino, M.; Papa, V.; Tursi, A.; Simeoni, B.; Lopetuso, L.R.; Vetrone, L.M.; Franceschi, F.; Rapaccini, G.; Gasbarrini, A.; Papa, A. Development and Validation of Predictive Assessment of Complicated Diverticulitis Score. J. Pers. Med. 2021, 11, 80. https://doi.org/10.3390/jpm11020080

AMA Style

Covino M, Papa V, Tursi A, Simeoni B, Lopetuso LR, Vetrone LM, Franceschi F, Rapaccini G, Gasbarrini A, Papa A. Development and Validation of Predictive Assessment of Complicated Diverticulitis Score. Journal of Personalized Medicine. 2021; 11(2):80. https://doi.org/10.3390/jpm11020080

Chicago/Turabian Style

Covino, Marcello, Valerio Papa, Antonio Tursi, Benedetta Simeoni, Loris R. Lopetuso, Lorenzo M. Vetrone, Francesco Franceschi, Gianludovico Rapaccini, Antonio Gasbarrini, and Alfredo Papa. 2021. "Development and Validation of Predictive Assessment of Complicated Diverticulitis Score" Journal of Personalized Medicine 11, no. 2: 80. https://doi.org/10.3390/jpm11020080

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