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预测急性憩室炎临床病程和结局的因素:年龄和种族的作用。

Predictors of Clinical Course and Outcomes of Acute Diverticulitis: The Role of Age and Ethnicity.

机构信息

Department of Internal Medicine, Hillel Yaffe Medical Center, Affiliated to the Technion Faculty of Medicine, Haifa 38100, Israel.

Department of Gastroenterology and Hepatology, Hillel Yaffe Medical Center, Affiliated to the Technion Faculty of Medicine, Haifa 38100, Israel.

出版信息

Medicina (Kaunas). 2021 Nov 19;57(11):1269. doi: 10.3390/medicina57111269.

Abstract

: Acute diverticulitis (AD) is the leading and most burdensome complication of colonic diverticulosis. However, risk factors for its development and predictors of its course are still poorly defined. In this regard, the association of a young age with a complicated course and worse outcome are still controversial. Moreover, little research has addressed the effect of ethnicity on the course of AD. The current study aimed to evaluate the impact of these variables on AD's course and outcome in the diverse and unique ethnic landscape of Israel. : We performed a retrospective review of the charts of patients with a radiologically confirmed diagnosis of AD. Patients' outcomes and disease course, including hospitalization duration, complications, and recurrent episodes, were documented and compared among different age and ethnic groups. Multivariate analysis was performed to identify predictors of complicated AD. Overall, 637 patients with AD were included, the majority (95%) had distal colon AD, and almost one quarter of them were aged less than 50 years. The majority of patients in the young age (<50) group were males (69.7%). Nonetheless, the rate of recurrent episodes (35.3% vs. 37.3%, = 0.19), hospitalization duration (5 ± 4.7 vs. 6 ± 3.2, = 0.09) and complications rate (17.3% vs. 13.7%; = 0.16) were similar for both age groups. In the ethnicity group analysis, Arab minority patients had a first episode of AD at a significantly younger age compared to their Jewish counterparts (51.8 vs. 59.4 years, < 0.001). However, factors such as a complicated course (16% vs. 15%; = 0.08) and relapsing episode rates (33% vs. 38%; = 0.36) did not differ significantly between groups. None of the variables, including young age and ethnic group, were predictors of complicated AD course in the multivariate analysis. AD is increasingly encountered in young patients, especially in ethnic minority groups, but neither ethnicity nor young age was associated with worse outcomes.

摘要

急性憩室炎(AD)是结肠憩室病的主要且最具负担的并发症。然而,其发展的危险因素和病程预测因素仍未明确定义。在这方面,年龄较轻与复杂的病程和较差的预后相关仍然存在争议。此外,很少有研究探讨种族对 AD 病程的影响。本研究旨在评估这些变量对以色列多样化和独特种族环境中 AD 病程和结局的影响。

我们对经影像学证实患有 AD 的患者的病历进行了回顾性分析。记录了患者的结局和疾病过程,包括住院时间、并发症和复发次数,并在不同年龄和种族群体之间进行了比较。进行了多变量分析以确定复杂 AD 的预测因素。

总体而言,纳入了 637 例 AD 患者,其中大多数(95%)患有远端结肠 AD,近四分之一的患者年龄小于 50 岁。在年轻(<50 岁)组中,大多数患者为男性(69.7%)。尽管如此,两个年龄组的复发次数(35.3%与 37.3%, = 0.19)、住院时间(5 ± 4.7 与 6 ± 3.2, = 0.09)和并发症发生率(17.3%与 13.7%; = 0.16)相似。在种族群体分析中,与犹太对照组相比,阿拉伯少数民族患者首次发生 AD 的年龄明显较小(51.8 岁与 59.4 岁, < 0.001)。然而,两组之间复杂病程(16%与 15%; = 0.08)和复发率(33%与 38%; = 0.36)等因素无显著差异。在多变量分析中,包括年龄较轻和种族群体在内的任何变量均不是复杂 AD 病程的预测因素。

AD 在年轻患者中越来越常见,尤其是在少数民族群体中,但无论是种族还是年龄较轻都与较差的结局无关。

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