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Assessment of clinical and laboratory parameters for the severity of acute diverticulitis in a Korean emergency department

대한응급의학회지 2020년 31권 2호 p.191 ~ 199
 ( Lee Stephen Gyung-Won ) - Seoul National University College of Medicine Department of Emergency Medicine

이휘재 ( Lee Hui-Jai ) - Seoul Metropolitan Government Seoul National University Boramae Medical Center Department of Emergency Medicine
신종환 ( Shin Jong-Hwan ) - Seoul National University College of Medicine Department of Emergency Medicine
유경민 ( You Kyoung-Min ) - Seoul National University College of Medicine Department of Emergency Medicine

Abstract


Objective: Practice guidelines for diverticulitis have been developed in countries where left-colon diverticulitis is dominant, but there is limited information on right-colon diverticulitis. This study examined the clinical characteristics and risk factors of clinically severe right-colon diverticulitis.

Method: A retrospective chart review of patients diagnosed with diverticulitis in an emergency department in Korea between 2013 and 2017 was performed. Clinically severe diverticulitis was defined as any cause of death, intensive care unit admission, surgery, or invasive intervention due to diverticulitis, and admission for seven or more hospital days. Multivariable logistic regression was used to identify the risk factors for clinically severe diverticulitis.

Results: This study analyzed 302 patients. Patients with older age (odds ratio [OR], 1.044; 95% confidence interval [CI], 1.009-1.080; P=0.013), complications observed on computed tomography (CT) (OR, 6.906; 95% CI, 2.514-18.968; P<0.001), rebound tenderness on a physical examination (OR, 2.542; 95% CI, 1.041-6.218; P=0.041), high alkaline phosphatase (ALP) levels (OR, 1.014; 95% CI, 1.002-1.026; P=0.026), and high C-reactive protein (CRP) levels (OR, 1.095; 95% CI, 1.017-1.178; P=0.013) were at higher risk of clinically severe diverticulitis.

Conclusion: Among patients diagnosed with right-colon diverticulitis in the emergency department, those of older age, distinct complications on CT, rebound tenderness on physical examination, high ALP, and high CRP levels are related to clinically severe disease.

키워드

Diverticulitis; Disease management; Risk factors; Ascending colon
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