Clinical Decision Rule of Lameris et al for the Diagnosis of Acute Diverticulitis in the Emergency Department

Patient selection: suspected acute diverticulitis

Clinical features for acute diverticulitis:

(1) direct tenderness only in the left lower quadrant (odds ratio 13.3)

(2) the absence of vomiting (odds ratio 9.2)

(3) C-reactive protein > 50 mg/L (odds ratio 4.7)

If all 3 features are present then 97% of patients had acute diverticulitis.

If the patient did not have all 3 features, then about half had diverticulitis. This group needs additional imaging studies to make the diagnosis.

An additional finding in patients with diverticulitis was the subacute onset of pain (odds ratio 2.3).