redictive score for diagnosing acute colonic diverticulitis in the emergency department: a retrospective study

redictive score for diagnosing acute colonic diverticulitis in the emergency department: a retrospective study

Acute diverticulitis is commonly misdiagnosed among patients with acute abdominal pain in the emergency department (ED). There are predictive scores that assist in the diagnosis of acute left-sided diverticulitis, but no scoring system is available for diagnosing acute diverticulitis without regard to the affected side. Therefore, developing a predictive score for diagnosing acute diverticulitis that is not limited to the left side will guide physicians in making a diagnosis and increase the appropriateness of computed tomography. This study aimed to establish a predictive score for diagnosing acute diverticulitis.

Of 424 patients who fulfilled the inclusion criteria, 72 (17%) were diagnosed with acute diverticulitis. The significant factors associated with acute diverticulitis were age ≥ 60 years (adjusted odds ratio (adj.OR) 2.23, 95% confidence interval (CI): 1.20 − 4.14, p = 0.01), duration of abdominal pain ≥ 48 h (adj.OR 2.64, 95% CI: 1.28 − 5.45, p = 0.017), history of a diverticulum (adj.OR 7.77, 95% CI: 3.27 − 18.45, p < 0.001), absence of nausea and vomiting (adj.OR 3.42, 95% CI: 1.65 − 7.10, p < 0.001), absence of anorexia (adj.OR 3.33, 95% CI: 1.34 − 8.33, p = 0.026), absence of tachycardia (adj.OR 3.51, 95% CI: 1.39 − 8.87, p = 0.003), and abdominal guarding (adj.OR 2.99, 95% CI: 1.52 − 5.91, p = 0.002). These predictive factors were converted into predictive scores for diagnosing acute diverticulitis. For the score of ≥ 4, the sensitivity and specificity were 73.24% (95% CI: 0.61–0.83) and 80.40% (95% CI: 0.76–0.84), respectively, and the negative predictive value was 93.71% (95% CI: 0.90–0.96). No significant signs, symptoms, or laboratory findings were associated with complicated diverticulitis.

Siriwimon Tantarattanapong, Choasita Glawsongkram & Wasuntaraporn Pethyabarn

https://bmcemergmed.biomedcentral.com/articles/10.1186/s12873-024-01127-2

BMC Emergency Medicine

09 november 2024

Fajar bagus W

PDF

English

text