TPTh 8.16 Inflammatory Markers as Predictors of Disease Severity and Outcomes in Acute Diverticulitis: A Cohort Study of NLR, PLR, WCC and CRP

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Abstract Background Identifying at-risk patients with acute diverticulitis early is necessary to intervene and use resources optimally. Routine inflammatory markers include white cell count (WCC) and C-reactive protein (CRP), and newer hematologic ratios, such as the neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR), might also be beneficial. Methods This retrospective cohort study included 268 adults with acute diverticulitis, confirmed by CT. Radiological findings were used to categorise patients as having either uncomplicated or complicated disease. Inflammatory markers (WCC, CRP, NLR and PLR) measured at presentation and 48 hours had been analysed. The Mann-Whitney U test was used to compare groups, Spearman's rank correlation to estimate correlations, and multivariate logistic regression to determine independent predictors of complicated diverticulitis. Findings There was a significant difference in all the inflammatory markers in patients with complicated diverticulitis (p < 0.001). CRP, NLR, PLR and WCC had positive correlations with disease complexity. On multivariate analysis, initial CRP (OR = 1.011, p = 0.001) and NLR (OR = 1.126, p = 0.043) were independent predictors of complicated disease, and WCC and PLR were not. The regression model had an overall classification accuracy of 76.5%. Conclusion CRP and NLR are sensitive, easily accessible biomarkers of predicting disease severity in acute diverticulitis, and potentially useful in clinical practice to promote early risk stratification.

Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.