Hemogram-Derived Ratios in the Prognosis of Acute Diverticulitis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Desing, Setting, and Participants
2.2. Variables of Interest
2.3. Data Sources and Measurements
2.4. Statistical Analysis
3. Results
3.1. General Characteristics
3.2. Patients’ Characteristics According to the Severity of Diverticulitis
3.3. Inflammatory Markers in Patients with AD
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Characteristic | Number (%) (n = 147) | Uncomplicated AD (n = 82) | Complicated AD (n = 65) | p-Value |
---|---|---|---|---|
Age (years), mean (SD) | 60.8 (14.05) | 62.05 (14) | 59.22 (14.06) | 0.226 |
Sex | ||||
female | 72 (48,97) | 40 (57.14) | 32 (56.14) | 0.957 |
Location of diverticula | ||||
rectum | 1 (0.79) | 1 (1.43) | 0 (0) | 1 |
sigmoid colon | 85 (66.93) | 38 (54.29) | 47 (82.46) | <0.001 |
descending colon | 13 (10.24) | 6 (8.57) | 7 (12.28) | 0.493 |
transverse colon | 4 (3.15) | 4 (5.71) | 0 (0) | 0.127 |
ascending colon | 3 (2.36) | 2 (2.86) | 1 (1.75) | 1 |
cecum | 0 (0) | |||
Symptoms | ||||
abdominal pain | 133 (91.72) | 72 (87.8) | 61 (96.83) | 0.051 |
right iliac region | 10 (6.9) | 5 (6.1) | 5 (7.94) | 0.747 |
right lumbar region | 4 (2.76) | 3 (3.66) | 1 (1.59) | 0.633 |
right hypochondriac region | 3 (2.07) | 3 (3.66) | 0 (0) | 0.258 |
epigastric region | 3 (2.07) | 3 (3.66) | 0 (0) | 0.258 |
left hypochondriac region | 5 (3.45) | 5 (6.1) | 0 (0) | 0.069 |
left lumbar region | 30 (20.69) | 20 (24.39) | 10 (15.87) | 0.209 |
left iliac region | 63 (43.45) | 38 (46.34) | 25 (39.68) | 0.423 |
hypogastric region | 19 (13.1) | 9 (10.98) | 10 (15.87) | 0.386 |
umbilical region | 1 (0.69) | 1 (1.22) | 0 (0) | 1 |
diffuse | 37 (25.52) | 13 (15.85) | 24 (38.1) | 0.002 |
diarrhea at admission | 43 (29.66) | 29 (35.37) | 14 (22.22) | 0.086 |
constipation at admission | 17 (11.72) | 14 (17.07) | 3 (4.76) | 0.022 |
nausea | 19 (13.1) | 12 (14.63) | 7 (11.11) | 0.533 |
vomiting | 17 (11.72) | 8 (9.76) | 9 (14.29) | 0.401 |
fever | 27 (18.62) | 11 (13.41) | 16 (25.4) | 0.066 |
Hinchey classification | ||||
stage 0 | 43 (29.25) | |||
stage IA | 39 (26.53) | |||
stage IB | 10 (6.8) | |||
stage II | 11 (7.48) | |||
stage III | 44 (29.93) | |||
stage IV | 0 (0) | |||
Treatment | ||||
conservative | 106 (72.11) | 80 (97.56) | 26 (40) | <0.001 |
drainage | 22 (14.97) | 1 (1.22) | 21 (32.31) | <0.001 |
surgery | ||||
without | 103 (70.07) | 80 (97.56) | 23 (35.38) | |
emergency | 37 (25.17) | 1 (1.22) | 36 (55.38) | <0.001 |
elective | 7 (4.76) | 1 (1.22) | 6 (9.23) | |
Recurrence | ||||
one episode | 12 | |||
two episodes | 2 | |||
≥ three episodes | 1 | |||
unknown | 1 |
Hinchey Classification | 0/Ia (n = 82) | Ib/II (n = 21) | III (n = 44) | p-Value |
---|---|---|---|---|
WBC (×109/mL), median (IQR) | 7.95 (6.45–9.84) | 11.11 (9.67–16.34) | 11.18 (7.29–13.26) | <0.001 (0.003/0.01/0.742) [n1 = 79, n2 = 20, n3 = 43] |
WBC, n (%) | < 0.001 | |||
Below NR | 0 (0) | 0 (0) | 2 (4.65) | |
NR | 64 (81.01) | 10 (50) | 19 (44.19) | |
Above NR | 15 (18.99) | 10 (50) | 22 (51.16) | |
Ly (×109/mL), median (IQR) | 1.6 (1.24–2) | 1.35 (1.05–1.72) | 1.44 (0.9–1.76) | 0.096 (0.336/0.233/1) [n1 = 75, n2 = 14, n3 = 36] |
Ly, n (%) | 0.012 | |||
Below NR | 9 (12) | 3 (21.43) | 13 (36.11) | |
NR | 66 (88) | 11 (78.57) | 23 (63.89) | |
M (×109/mL), median (IQR) | 0.47 (0.37–0.71) | 0.76 (0.52–0.92) | 0.55 (0.4–0.74) | 0.169 (0.163/0.85/0.523) [n1 = 69, n2 = 10, n3 = 25] |
M, n (%) | 0.017 | |||
Below NR | 0 (0) | 0 (0) | 2 (8) | |
NR | 58 (84.06) | 5 (50) | 18 (72) | |
Above NR | 11 (15.94) | 5 (50) | 5 (20) | |
N (×109/mL), median (IQR) | 5.38 (4.16–7.36) | 8.69 (6.96–12.3) | 9.48 (5.38–11.96) | <0.001 (0.004/0.009/0.983) [n1 = 75, n2 = 14, n3 = 36] |
N, n (%) | <0.001 | |||
Below NR | 1 (1.33) | 0 (0) | 1 (2.78) | |
NR | 54 (72) | 4 (28.57) | 13 (36.11) | |
Above NR | 20 (26.67) | 10 (71.43) | 22 (61.11) | |
P (×103/mL), median (IQR) | 239 (195.5–273.5) | 300 (272.5–447.5) | 257 (227–354) | <0.001 (<0.001/0.175/0.051) [n1 = 79, n2 = 20, n3 = 42] |
P, n (%) | 0.01 | |||
Below NR | 4 (5.06) | 0 (0) | 4 (9.52) | |
NR | 72 (91.14) | 15 (75) | 31 (73.81) | |
Above NR | 3 (3.8) | 5 (25) | 7 (16.67) |
Hinchey Classification | 0/Ia (n = 82) | Ib/II (n = 21) | III (n = 44) | p-Value |
---|---|---|---|---|
MLR, median (IQR) | 0.35 (0.21–0.42) | 0.43 (0.4–0.6) | 0.42 (0.28–0.62) | 0.013 (0.101/0.133/0.738) [n1 = 69, n2 = 10, n3 = 25] |
NLR, median (IQR) | 3.53 (2.51–4.81) | 5.86 (4.14–13.18) | 6.96 (5.1–10.52) | <0.001 (0.006/<0.001/0.976) [n1 = 75, n2 = 14, n3 = 36] |
PDW, median (IQR) | 13.75 (11.83–16) | 12.9 (10.75–15.75) | 13.95 (11.12–15.9) | 0.318 (0.383/0.614/0.767) [n1 = 70, n2 = 16, n3 = 40] |
PLR, median (IQR) | 140.15 (108.1–214.34) | 278.32 (204.28–426.21) | 228.7 (149.68–400.46) | <0.001 (0.002/0.006/0.541) [n1 = 75, n2 = 14, n3 = 36] |
RDW, median (IQR) | 42.3 (40.1–46.6) | 44.65 (41.18–50.9) | 43.3 (41.5–46.2) | 0.443 (0.584/0.755/0.782) [n1 = 65, n2 = 12, n3 = 29] |
SII, median (IQR) | 773.24 (539.28–1173.68) | 2856.29 (1434.65–3631.29) | 1689.24 (1310.22–3532.76) | <0.001 (<0.001/<0.001/0.775) [n1 = 75, n2 = 14, n3 = 36] |
Characteristic | AUROC (95% CI) | Cutoff | Se | Sp |
---|---|---|---|---|
MLR | 0.665 (0.542–0.777) | 0.38 | 65.7 | 65.2 |
NLR | 0.773 (0.676–0.857) | 4.06 | 80 | 69.3 |
PLR | 0.725 (0.63–0.813) | 144.38 | 80 | 56 |
SII | 0.812 (0.73–0.888) | 1200 | 82 | 76 |
SII vs. NLR | p = 0.111 | |||
SII vs. MLR | p = 0.027 | |||
SII vs. PLR | p = 0.019 | |||
NLR vs. PLR | p = 0.323 |
Characteristic | AUROC (95% CI) | Cutoff | Se | Sp |
---|---|---|---|---|
MLR | 0.614 (0.474–0.738) | 0.51 | 48 | 81 |
NLR | 0.737 (0.629–0.834) | 5.61 | 72.2 | 76.4 |
PLR | 0.65 (0.53–0.754) | 144.38 | 77.8 | 49.4 |
SII | 0.738 (0.632–0.831) | 1200 | 83.3 | 67.4 |
Characteristic | HR | p-Value |
---|---|---|
MLR ≥ median | 1.27 (95% CI 0.45–3.6) | 0.651 |
NLR ≥ median | 1.57 (95% CI 0.61–4.08) | 0.347 |
PLR ≥ median | 1.31 (95% CI 0.48–3.53) | 0.597 |
SII ≥ median | 1.57 (95% CI 0.61–4.08) | 0.347 |
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Sabo, C.M.; Leucuta, D.-C.; Simiraș, C.; Deac, I.Ș.; Ismaiel, A.; Dumitrascu, D.L. Hemogram-Derived Ratios in the Prognosis of Acute Diverticulitis. Medicina 2023, 59, 1523. https://doi.org/10.3390/medicina59091523
Sabo CM, Leucuta D-C, Simiraș C, Deac IȘ, Ismaiel A, Dumitrascu DL. Hemogram-Derived Ratios in the Prognosis of Acute Diverticulitis. Medicina. 2023; 59(9):1523. https://doi.org/10.3390/medicina59091523
Chicago/Turabian StyleSabo, Cristina Maria, Daniel-Corneliu Leucuta, Constantin Simiraș, Ioana Ștefania Deac, Abdulrahman Ismaiel, and Dan L. Dumitrascu. 2023. "Hemogram-Derived Ratios in the Prognosis of Acute Diverticulitis" Medicina 59, no. 9: 1523. https://doi.org/10.3390/medicina59091523