Division of Gastroenterology and Hepatology, Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea.
Gut Liver. 2013 Jul;7(4):443-9. doi: 10.5009/gnl.2013.7.4.443. Epub 2013 Jul 11.
BACKGROUND/AIMS: Acute complicated diverticulitis can be subdivided into moderate diverticulitis and severe diverticulitis. Although there have been numerous studies on the risk factors for complicated diverticulitis, little research has focused on severe diverticulitis. This study was designed to identify the risk factors for severe diverticulitis in an acute diverticulitis attack using the modified Hinchey classification.
Patients were included if they had any evidence of acute diverticulitis detected by computed tomography. The patients were subdivided into severe diverticulitis (Hinchey class ≥Ib; abscesses or peritonitis) and moderate diverticulitis (Hinchey class Ia; pericolic inflammation) groups.
Of the 128 patients, 25 exhibited severe diverticulitis, and 103 exhibited moderate diverticulitis. In a multivariate analysis, age >50 years (odds ratio [OR], 5.27; p=0.017), smoking (OR, 3.61; p=0.044), comorbidity (OR, 4.98; p=0.045), leukocytosis (OR, 7.70; p=0.003), recurrence (OR, 4.95; p=0.032), and left-sided diverticulitis (OR, 6.92; p=0.006) were significantly associated with severe diverticulitis.
This study suggests that the risk factors for severe diverticulitis are age >50 years, smoking, comorbidity, leukocytosis, recurrent episodes, and left-sided diverticulitis.
背景/目的：急性复杂型憩室炎可进一步分为中度复杂型憩室炎和重度复杂型憩室炎。虽然已经有大量研究探讨了复杂型憩室炎的危险因素，但针对重度复杂型憩室炎的研究却很少。本研究旨在使用改良 Hinchey 分级来确定急性憩室炎发作时重度复杂型憩室炎的危险因素。
纳入任何经计算机断层扫描检查发现有急性憩室炎证据的患者。将患者分为重度复杂型憩室炎（Hinchey 分级≥Ib；脓肿或腹膜炎）和中度复杂型憩室炎（Hinchey 分级 Ia；结肠旁炎症）组。
在 128 例患者中，25 例表现为重度复杂型憩室炎，103 例表现为中度复杂型憩室炎。多变量分析显示，年龄>50 岁（比值比 [OR]，5.27；p=0.017）、吸烟（OR，3.61；p=0.044）、合并症（OR，4.98；p=0.045）、白细胞增多（OR，7.70；p=0.003）、复发（OR，4.95；p=0.032）和左侧憩室炎（OR，6.92；p=0.006）与重度复杂型憩室炎显著相关。
本研究表明，重度复杂型憩室炎的危险因素包括年龄>50 岁、吸烟、合并症、白细胞增多、反复发作和左侧憩室炎。
