Pietrzak Anna M, Chreptowicz Agnieszka, Wieszczy-Szczepanik Paulina, Mróz Andrzej
Second Department of Gastroenterology, Centre of Postgraduate Medical Education, Warszawa, Poland; Department of Gastroenterology, Bielanski Hospital, Warszawa, Poland.
Endoscopy Department, Ministry of the Interior and Administration Polyclinic, Koszalin, Poland
Pol Arch Intern Med. 2025 Feb 27;135(2). doi: 10.20452/pamw.16915. Epub 2025 Jan 2.
Recently, a 3‑step endoscopic scale, known as the Diverticular Inflammation and Complication Assessment (DICA), was introduced to predict the course of diverticular disease (DD), yielding some promising outcomes. However, analyses were performed only for symptomatic individuals.
The aim of our study was to prospectively evaluate the predictive value of DICA in asymptomatic individuals with no previous diagnosis of DD who underwent colorectal cancer screening colonoscopy.
We performed a prospective cohort study. All consecutive individuals, aged 55-65 years undergoing screening colonoscopy in a single center during a 6‑month period were assessed for eligibility. Those with diverticulosis were followed‑up for 12 months. Information on the course of the disease, symptoms, treatment, diverticulitis episodes confirmed by health care professionals, complications, and hospital admissions was obtained via telephone interviews conducted by doctors. Detailed patient data and medical conditions were evaluated.
Out of 3879 participants, 958 (24.7%) had diverticula. Of these, 872 (mean [SD] age, 61 [2] years; 49.8% women) completed the study. About 83.5%, 12.85%, and 3.67% of the patients were classified into the DICA 1, DICA 2, and DICA 3 group, respectively. Diverticulitis occurred in 12 (1.37%) patients. Hospital admission was needed in 5 of them. No surgical interventions were necessary. There were no significant relationships between the DICA score and diverticulitis or hospital admission. Previous abdominal surgery and appendectomy, the presence and severity of pain, bloating, and previous DD treatment were the only factors predisposing to diverticulitis.
In our cohort, the DICA scale had no predictive value for the occurrence of diverticulitis. Hence, it has a limited predictive value for occurrence of this condition and more studies on bigger cohorts are necessary to test its usefulness.
最近，一种三步内镜评分法，即憩室炎和并发症评估（DICA）被引入，用于预测憩室病（DD）的病程，取得了一些有前景的结果。然而，分析仅针对有症状的个体进行。
我们研究的目的是前瞻性评估DICA在接受结直肠癌筛查结肠镜检查且既往未诊断为DD的无症状个体中的预测价值。
我们进行了一项前瞻性队列研究。在6个月期间，对在单一中心接受筛查结肠镜检查的所有连续55 - 65岁个体进行资格评估。患有憩室病的个体随访12个月。通过医生进行的电话访谈获取有关疾病病程、症状、治疗、经医疗保健专业人员确认的憩室炎发作、并发症和住院情况的信息。评估详细的患者数据和医疗状况。
在3879名参与者中，958人（24.7%）有憩室。其中，872人（平均[标准差]年龄，61[2]岁；49.8%为女性）完成了研究。分别约83.5%、12.85%和3.67%的患者被分类到DICA 1、DICA 2和DICA 3组。12名（1.37%）患者发生了憩室炎。其中5人需要住院治疗。无需手术干预。DICA评分与憩室炎或住院治疗之间无显著关系。既往腹部手术和阑尾切除术、疼痛、腹胀的存在及严重程度以及既往DD治疗是仅有的易患憩室炎的因素。
在我们的队列中，DICA评分对憩室炎的发生没有预测价值。因此，它对这种情况发生的预测价值有限，需要对更大的队列进行更多研究以检验其有用性。
