Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study

A. Tursi*, G. Brandimarte, Mario F. Di, M. L. Annunziata, M. Bafutto, M. A. Bianco, R. Colucci, R. Conigliaro, S. Danese, Bastiani R. De, W. Elisei, R. Escalante, R. Faggiani, L. Ferrini, G. Forti, G. Latella, M. G. Graziani, E. C. Oliveira, Alfredo Papa, A. PennaP. Portincasa, K. Soreide, A. Spadaccini, P. Usai, S. Bonovas, C. Scarpignato, M. Picchio, P. G. Lecca, C. Zampaletta, C. Cassieri, A. Damiani, K. F. Desserud, S. Fiorella, R. Landi, E. Goni, M. A. Lai, F. Pigo, G. Rotondano, G. Schiaccianoce

*Autore corrispondente per questo lavoro

Risultato della ricerca: Contributo in rivistaArticolo

30 Citazioni (Scopus)

Abstract

Background: Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification has been recently developed for patients suffering from diverticulosis and diverticular disease. Aims: We assessed retrospectively the predictive value of DICA in patients for whom endoscopic data and clinical follow-up were available. Methods: For each patient, we recorded: age, severity of DICA, presence of abdominal pain, C-reactive protein and faecal calprotectin test (if available) at the time of diagnosis; months of follow-up; therapy taken during the follow-up to maintain remission (if any); occurrence/recurrence of diverticulitis; need of surgery. Results: We enrolled 1651 patients (793 M, 858 F, mean age 66.6 ± 11.1 years): 939 (56.9%) patients were classified as DICA 1, 501 (30.3%) patients as DICA 2 and 211 (12.8%) patients as DICA 3. The median follow-up was 24 (9–38) months. Acute diverticulitis (AD) occurred/recurred in 263 (15.9%) patients; surgery was necessary in 57 (21.7%) cases. DICA was the only factor significantly associated to the occurrence/recurrence of diverticulitis and surgery either at univariate (χ2= 405.029; p < 0.0001) or multivariate analysis (hazard ratio = 4.319, 95% confidence interval (CI) 3.639–5.126; p < 0.0001). Only in DICA 2 patients was therapy effective for prevention of AD occurrence/recurrence with a hazard ratio (95% CI) of 0.598 (0.391–0.914) (p = 0.006, log rank test). Mesalazine-based therapies reduced the risk of AD occurrence/recurrence and needs of surgery with a hazard ratio (95% CI) of 0.2103 (0.122–0.364) and 0.459 (0.258–0.818), respectively. Conclusions: DICA classification is a valid parameter to predict the risk of diverticulitis occurrence/recurrence in patients suffering from diverticular disease of the colon.
Lingua originaleInglese
pagine (da-a)604-613
Numero di pagine10
RivistaUnited European Gastroenterology Journal
Volume4
Numero di pubblicazione4
DOI
Stato di pubblicazionePubblicato - 2016

All Science Journal Classification (ASJC) codes

  • Oncologia
  • Gastroenterologia

Keywords

  • Colonoscopy
  • colon
  • diverticular disease
  • endoscopic classification
  • outcome
  • surgery

Fingerprint

Entra nei temi di ricerca di 'Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study'. Insieme formano una fingerprint unica.

Cita questo