Jaung et al identified factors predictive of poor outcome for a patient with acute diverticulitis. These can help to identify a patient who may benefit from more aggressive management. The authors are from Auckland City Hospital, University of Auckland and Counties Manukau Health in New Zealand.
Patient selection: acute diverticulitis
Severe outcomes: need for procedural intervention, hospital stay > 7 days, 30-day readmission
Predictors for 30-day readmission:
(1) pain score >= 8 on a 10 cm VAS scale (odds ratio 6.1)
(2) first episode of acute diverticulitis (odds ratio 2.5)
Predictors for a need for a procedural intervention:
(1) SIRS (odds ratio 3.0)
Predictors for severe outcome:
(1) regular steroid or immunosuppressive therapy (odds ratio 4.3)
(2) pain score >= 8 on a 10 cm VAS scale (odds ratio 5.9)
(3) CRP >= 200 mg/L (odds ratio 4.1)
A higher temperature is listed as a risk factor for a severe outcome with an odds ratio of 1.5, but the data is not impressive (mean 36.9 with range 36.5-37.3 in affected vs 36.3 with range 36.2-37.2 in unaffected).
