Platelet to lymphocyte ratio is a risk factor for failure of non-operative treatment of colonic diverticulitis

Abstract

Non-operative treatment is the mainstay of colonic diverticulitis, but some patients require surgery due to non-operative treatment failure. This study aims to identify risk factors for the failure of non-operative treatment of colonic diverticulitis. From January 2011 to December 2020, we retrospectively reviewed 2362 patients with non-operative treatment for first-attack acute diverticulitis. Patients were categorized into non-operative treatment success or failure groups. Clinical characteristics and serum inflammatory markers were analyzed by multivariable logistic regression to determine risk factors for non-operative treatment failure of colonic diverticulitis. Overall, 2.2% (n = 50) of patients underwent delayed surgery within 30 days (median 4.0 [3.0; 8.0]) due to non-operative treatment failure. Multivariable logistic regression identified that platelet to lymphocyte ratio (odds ratio [OR], 4.2; 95% confidence interval [CI], 0.05–0.13; p < 0.001), diabetes mellitus (OR, 2.2; 95% CI, 0.01–0.09; p = 0.025), left-sided colonic diverticulitis (OR, 4.1; 95% CI, 0.04–0.13; p < 0.001), and modified Hinchey classification (OR, 6.2; 95% CI, 0.09–0.17; p < 0.001) were risk factors for non-operative treatment failure. Platelet to lymphocyte ratio (PLR) is a potential risk factor for the non-operative treatment failure of acute first-attack colonic diverticulitis. Therefore, patients with higher PLR during non-operative treatment should be monitored with special caution.

Evaluación de la utilidad pronóstica de los índices plaquetas-linfocitos y neutrófilos-linfocitos en pacientes con enfermedad diverticular complicada

“…En 2021, Palacios Huatuco et al 20 reportaron el INL en una cohorte de 325 pacientes con un punto de cohorte > 4.2 como un riesgo de complicaciones agudas en la DA con una sensibilidad del 80% y una especificidad del 64%. Kim et al 25 describieron el IPL como un factor de riesgo (OR: 4.2; IC95%: 0.05-0.17; p < 0.001) para falla de tratamiento convencional en un cuadro de DA, con un punto de cohorte de 167.77, con una sensibilidad del 58% y una especificidad del 73%. Sabo et al describieron el uso de índices hematológicos en 147 pacientes, encontrando el INL, el IPL y la inflamación sistémica, definida como (P × N)/L, como marcadores para identificar DA complicada, sin diferencia entre Hinchey IB y grados mayores 26 .…”