Kartal Bahadır, Tutan Mehmet Berksun, Turhan Veysel Barış, Uğur Furkan, Alkurt Ertuğrul Gazi
Department of General Surgery, Erol Olçok Training and Research Hospital, 19040 Çorum, Turkey.
Department of General Surgery, Alaca State Hospital, 19600 Çorum, Turkey.
Medicina (Kaunas). 2025 Mar 26;61(4):592. doi: 10.3390/medicina61040592.
: This study aimed to investigate the role of serum sodium levels as an independent predictor of complications in acute diverticulitis and to evaluate their diagnostic value alongside inflammatory markers. : A total of 134 patients diagnosed with acute diverticulitis between June 2018 and January 2024 at the Erol Olçok Training and Research Hospital were retrospectively analyzed. Complicated diverticulitis was defined based on the presence of an abscess, perforation, fistula, or obstruction classified as Hinchey stage II-IV. Serum sodium, CRP, and WBC levels were assessed for their predictive value. Statistical analyses included ROC analysis to determine optimal thresholds and logistic regression to evaluate independent predictors. : A total of 29.1% of the patients were classified as having complicated diverticulitis. Serum sodium levels were significantly lower in the complicated group (median: 133 mmol/L, < 0.001), whereas CRP (median: 86.5 mg/L, < 0.001) and WBC levels (median: 11.62 × 10/µL, = 0.001) were higher. The ROC analysis identified <135.5 mmol/L as the optimal threshold for serum sodium, with a 94.9% sensitivity and 94.7% specificity, making it the strongest predictor. The logistic regression revealed that each unit decrease in serum sodium increased the risk of complications by 5.7 times ( < 0.001). : Serum sodium levels are an independent and strong predictor of complications in acute diverticulitis. When used alongside CRP and WBC levels, diagnostic accuracy can be enhanced, leading to improved patient management.
本研究旨在探讨血清钠水平作为急性憩室炎并发症独立预测指标的作用，并评估其与炎症标志物相比的诊断价值。对2018年6月至2024年1月在埃罗尔·奥尔库克培训与研究医院诊断为急性憩室炎的134例患者进行回顾性分析。复杂憩室炎根据存在脓肿、穿孔、瘘管或分类为欣奇II - IV期的梗阻来定义。评估血清钠、CRP和白细胞水平的预测价值。统计分析包括确定最佳阈值的ROC分析和评估独立预测指标 的逻辑回归。共有29.1%的患者被归类为患有复杂憩室炎。复杂组的血清钠水平显著较低（中位数：133 mmol/L，<0.001），而CRP（中位数：86.5 mg/L，<0.001）和白细胞水平（中位数：11.62×10/µL，=0.001）较高。ROC分析确定血清钠的最佳阈值<135.5 mmol/L，敏感性为94.9%，特异性为94.7%，使其成为最强的预测指标。逻辑回归显示血清钠每降低一个单位，并发症风险增加5.7倍（<0.001）。血清钠水平是急性憩室炎并发症的独立且强有力的预测指标。与CRP和白细胞水平一起使用时，可提高诊断准确性，从而改善患者管理。
