TY - JOUR
T1 - Prognostic performance of the ‘DICA’ endoscopic classification and the ‘CODA’ score in predicting clinical outcomes of diverticular disease: an international, multicentre, prospective cohort study
AU - Tursi, Antonio
AU - Brandimarte, Giovanni
AU - Di Mario, Francesco
AU - Elisei, Walter
AU - Picchio, Marcello
AU - Allegretta, Leonardo
AU - Annunziata, Maria Laura
AU - Bafutto, Mauro
AU - Bassotti, Gabrio
AU - Bianco, Maria Antonietta
AU - Colucci, Raffaele
AU - Conigliaro, Rita
AU - Dumitrascu, Dan
AU - Escalante, Ricardo
AU - Ferrini, Luciano
AU - Forti, Giacomo
AU - Franceschi, Marilisa
AU - Graziani, Maria Giovanna
AU - Lammert, Frank
AU - Latella, Giovanni
AU - Maconi, Giovanni
AU - Nardone, Gerardo
AU - Camara de Castro Oliveira, Lucia
AU - Chaves Oliveira, Enio
AU - Papa, Alfredo
AU - Papagrigoriadis, Savvas
AU - Pietrzak, Anna
AU - Pontone, Stefano
AU - Poskus, Tomas
AU - Pranzo, Giuseppe
AU - Reichert, Matthias Christian
AU - Rodinò, Stefano
AU - Regula, Jaroslaw
AU - Scaccianoce, Giuseppe
AU - Scaldaferri, Franco
AU - Vassallo, Roberto
AU - Zampaletta, Costantino
AU - Zullo, Angelo
AU - Piovani, Daniele
AU - Bonovas, Stefanos
AU - Danese, Silvio
PY - 2022
Y1 - 2022
N2 - Objective To investigate the predictive value of the Diverticular Inflammation and Complication Assessment (DICA) classification and to develop and validate a combined endoscopic-clinical score predicting clinical outcomes of diverticulosis, named Combined Overview on Diverticular Assessment (CODA).Design A multicentre, prospective, international cohort study.Setting 43 gastroenterology and endoscopy centres located in Europe and South America.Participants 2215 patients (2198 completing the study) at the first diagnosis of diverticulosis/diverticular disease were enrolled. Patients were scored according to DICA classifications.Interventions A 3-year follow-up was performed.Main outcome measures To predict the acute diverticulitis and the surgery according to DICA classification. Survival methods for censored observation were used to develop and validate a novel combined endoscopic-clinical score for predicting diverticulitis and surgery (CODA score).Results The 3-year cumulative probability of diverticulitis and surgery was of 3.3% (95% CI 2.5% to 4.5%) in DICA 1, 11.6% (95% CI 9.2% to 14.5%) in DICA 2 and 22.0% (95% CI 17.2% to 28.0%) in DICA 3 (p<0.001), and 0.15% (95% CI 0.04% to 0.59%) in DICA 1, 3.0% (95% CI 1.9% to 4.7%) in DICA 2 and 11.0% (95% CI 7.5% to 16.0%) in DICA 3 (p<0.001), respectively. The 3-year cumulative probability of diverticulitis and surgery was <= 4%, and <= 0.7% in CODA A; 10% and >2.5% in CODA C, respectively. The CODA score showed optimal discrimination capacity in predicting the risk of surgery in the development (c-statistic: 0.829; 95% CI 0.811 to 0.846) and validation cohort (c-statistic: 0.943; 95% CI 0.905 to 0.981).Conclusions DICA classification has a significant role in predicting the risk of diverticulitis and surgery in patients with diverticulosis, which is significantly enhanced by the CODA score.
AB - Objective To investigate the predictive value of the Diverticular Inflammation and Complication Assessment (DICA) classification and to develop and validate a combined endoscopic-clinical score predicting clinical outcomes of diverticulosis, named Combined Overview on Diverticular Assessment (CODA).Design A multicentre, prospective, international cohort study.Setting 43 gastroenterology and endoscopy centres located in Europe and South America.Participants 2215 patients (2198 completing the study) at the first diagnosis of diverticulosis/diverticular disease were enrolled. Patients were scored according to DICA classifications.Interventions A 3-year follow-up was performed.Main outcome measures To predict the acute diverticulitis and the surgery according to DICA classification. Survival methods for censored observation were used to develop and validate a novel combined endoscopic-clinical score for predicting diverticulitis and surgery (CODA score).Results The 3-year cumulative probability of diverticulitis and surgery was of 3.3% (95% CI 2.5% to 4.5%) in DICA 1, 11.6% (95% CI 9.2% to 14.5%) in DICA 2 and 22.0% (95% CI 17.2% to 28.0%) in DICA 3 (p<0.001), and 0.15% (95% CI 0.04% to 0.59%) in DICA 1, 3.0% (95% CI 1.9% to 4.7%) in DICA 2 and 11.0% (95% CI 7.5% to 16.0%) in DICA 3 (p<0.001), respectively. The 3-year cumulative probability of diverticulitis and surgery was <= 4%, and <= 0.7% in CODA A; 10% and >2.5% in CODA C, respectively. The CODA score showed optimal discrimination capacity in predicting the risk of surgery in the development (c-statistic: 0.829; 95% CI 0.811 to 0.846) and validation cohort (c-statistic: 0.943; 95% CI 0.905 to 0.981).Conclusions DICA classification has a significant role in predicting the risk of diverticulitis and surgery in patients with diverticulosis, which is significantly enhanced by the CODA score.
KW - diverticular disease
KW - endoscopy
KW - diverticular disease
KW - endoscopy
UR - https://publicatt.unicatt.it/handle/10807/268179
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85131770943&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85131770943&origin=inward
U2 - 10.1136/gutjnl-2021-325574
DO - 10.1136/gutjnl-2021-325574
M3 - Article
SN - 0017-5749
VL - 71
SP - 1350
EP - 1358
JO - Gut
JF - Gut
IS - 7
ER -
SDG 3 Good Health and Well-being