Department of Anesthesiology and Pain Medicine, Chuncheon Sacred Heart Hospital, Hallym University College of Medicine, Chuncheon, 24253, South Korea.
Department of Surgery, CHA Bundang Medical Center, CHA University School of Medicine, Seongnam, 13496, South Korea.
Sci Rep. 2023 Mar 16;13(1):4377. doi: 10.1038/s41598-023-31570-3.
Non-operative treatment is the mainstay of colonic diverticulitis, but some patients require surgery due to non-operative treatment failure. This study aims to identify risk factors for the failure of non-operative treatment of colonic diverticulitis. From January 2011 to December 2020, we retrospectively reviewed 2362 patients with non-operative treatment for first-attack acute diverticulitis. Patients were categorized into non-operative treatment success or failure groups. Clinical characteristics and serum inflammatory markers were analyzed by multivariable logistic regression to determine risk factors for non-operative treatment failure of colonic diverticulitis. Overall, 2.2% (n = 50) of patients underwent delayed surgery within 30 days (median 4.0 [3.0; 8.0]) due to non-operative treatment failure. Multivariable logistic regression identified that platelet to lymphocyte ratio (odds ratio [OR], 4.2; 95% confidence interval [CI], 0.05-0.13; p < 0.001), diabetes mellitus (OR, 2.2; 95% CI, 0.01-0.09; p = 0.025), left-sided colonic diverticulitis (OR, 4.1; 95% CI, 0.04-0.13; p < 0.001), and modified Hinchey classification (OR, 6.2; 95% CI, 0.09-0.17; p < 0.001) were risk factors for non-operative treatment failure. Platelet to lymphocyte ratio (PLR) is a potential risk factor for the non-operative treatment failure of acute first-attack colonic diverticulitis. Therefore, patients with higher PLR during non-operative treatment should be monitored with special caution.
非手术治疗是结肠憩室炎的主要治疗方法，但由于非手术治疗失败，一些患者需要手术。本研究旨在确定结肠憩室炎非手术治疗失败的危险因素。
从 2011 年 1 月至 2020 年 12 月，我们回顾性分析了 2362 例首次急性憩室炎接受非手术治疗的患者。患者分为非手术治疗成功组和失败组。采用多变量逻辑回归分析临床特征和血清炎症标志物，确定结肠憩室炎非手术治疗失败的危险因素。
总体而言，2.2%（n=50）的患者因非手术治疗失败，在 30 天内（中位数 4.0[3.0；8.0]）行延迟手术。多变量逻辑回归分析发现血小板与淋巴细胞比值（比值比[OR]，4.2；95%置信区间[CI]，0.05-0.13；p<0.001）、糖尿病（OR，2.2；95%CI，0.01-0.09；p=0.025）、左侧结肠憩室炎（OR，4.1；95%CI，0.04-0.13；p<0.001）和改良 Hinchey 分级（OR，6.2；95%CI，0.09-0.17；p<0.001）是非手术治疗失败的危险因素。
血小板与淋巴细胞比值（PLR）是急性首次发作结肠憩室炎非手术治疗失败的潜在危险因素。因此，在非手术治疗过程中 PLR 较高的患者应特别谨慎监测。
