Sallinen et al evaluated patients with diverticulitis and identified patients at increased risk for recurrence. The authors are from the University of Helsinski.
Patient selection: diverticulitis
Features of diverticulitis:
(1) diverticuli on CT scan
(2) clinical findings (fever, elevated C-reactive protein, left lower abdominal pain)
Features of complicated diverticulitis:
(1) acute diverticulitis on imaging studies
(2) abscess, fistula, obstruction, peritonitis, large amount of intra-peritoneal fluid, and/or free air.
Parameter:
(1) history of diverticulitis (previous to current episode)
(2) abscess on CT scan
(3) therapy with corticosteroids
|
Parameter
|
Finding
|
Points
|
|
previous diverticulitis
|
none
|
0
|
|
|
yes
|
1
|
|
abscess on CT scan
|
no
|
0
|
|
|
yes
|
2
|
|
corticosteroid therapy
|
no
|
0
|
|
|
yes
|
3
|
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum total score: 0
• maximum total score: 6
• The higher the score the greater the risk for recurrence of complicated diverticulitis.
|
Total Score
|
Risk of Recurrent Complicated Diverticulitis
|
|
<= 2
|
low
|
|
3 to 6
|
high
|
The risk for recurrence of uncomplicated diverticulitis increased with the number of previous episodes:
(1) If the patient had a history of 1 or 2 previous episodes, then the hazard ratio was 1.6.
(2) If the patient had a history of 3 or more episodes then the hazard ratio was 3.2.
