Diverticular Inflammation and Complication Assessment classification, CODA score and fecal calprotectin in clinical assessment of patients with diverticular disease: A decision curve analysis

被引：4

作者：

Tursi, Antonio ^{[1
,2
,3
]}

Piovani, Daniele ^{[4
,5
]}

Brandimarte, Giovanni ^{[6
]}

Di Mario, Francesco ^{[7
]}

Elisei, Walter ^{[8
]}

Picchio, Marcello ^{[9
]}

Allegretta, Leonardo ^{[10
]}

Annunziata, Maria Laura ^{[11
]}

Bafutto, Mauro ^{[12
]}

Bassotti, Gabrio ^{[13
]}

Bianco, Maria Antonia ^{[14
]}

Colucci, Raffaele ^{[15
]}

Conigliaro, Rita L. ^{[16
]}

Dumitrascu, Dan L. ^{[17
]}

Escalante, Ricardo ^{[18
]}

Ferrini, Luciano ^{[19
]}

Forti, Giacomo ^{[20
]}

Franceschi, Marilisa ^{[21
]}

Graziani, Maria Giovanna ^{[22
]}

Lammert, Frank ^{[23
,24
]}

Latella, Giovanni ^{[25
]}

Maconi, Giovanni ^{[26
]}

Compare, Debora ^{[27
]}

Nardone, Gerardo ^{[27
]}

Oliveira, Lucia Camara De Castro ^{[28
]}

Oliveira, Enio Chaves ^{[29
]}

Papa, Alfredo ^{[30
]}

Papagrigoriadis, Savvas ^{[31
]}

Pietrzak, Anna ^{[32
]}

Pontone, Stefano ^{[33
]}

Poskus, Tomas ^{[34
]}

Pranzo, Giuseppe ^{[35
]}

Reichert, Matthias Christian ^{[23
]}

Rodino, Stefano ^{[36
]}

Regula, Jaroslaw ^{[32
]}

Scaccianoce, Giuseppe ^{[37
]}

Scaldaferri, Franco ^{[30
]}

Vassallo, Roberto ^{[38
]}

Zampaletta, Costantino ^{[39
]}

Zullo, Angelo ^{[40
]}

Spaziani, Erasmo ^{[41
]}

Bonovas, Stefanos ^{[4
,5
]}

Danese, Silvio ^{[42
,43
]}

DICA Int Grp

机构：

[1] Via Torino 49, I-76123 Andria, Barletta Andria, Italy

[2] ASL BAT, Terr Gastroenterol Serv, Andria, Barletta Adria, Italy

[3] Catholic Univ, Postgrad Sch Digest Dis, Dept Med & Surg Sci, Rome, Italy

[4] Humanitas Univ, Dept Biomed Sci, Milan, Italy

[5] IRCCS Humanitas Res Hosp, Milan, Italy

[6] Cristo Re Hosp, Div Internal Med & Gastroenterol, Rome, Italy

[7] Univ Parma, Dept Med & Surg Sci, Gastroenterol Unit, Parma, Italy

[8] San Camillo Hosp, Div Gastroenterol, Rome, Italy

[9] P Colombo Hosp, Div Surg, ASL RM6, Rome, Italy

[10] Santa Caterina Novella Hosp, Div Gastroenterol, Galatina, Lecce, Italy

[11] San Donato Hosp, Div Gastroenterol, Milan, Italy

[12] Inst Gastroenterol & Digest Endoscopy, Goiania, GO, Brazil

[13] Univ Perugia, Santa Maria della Misericordia Univ Hosp, Dept Med & Surg, Gastroenterol & Hepatol Unit, Perugia, Italy

[14] T Maresca Hosp, Div Gastroenterol, Naples, Italy

[15] San Matteo degli Infermi Hosp, Digest Endoscopy Unit, Spoleto, Perugia, Italy

[16] St Agostino Estense Hosp, Digest Endoscopy Unit, Baggiovara, Modena, Italy

[17] Iuliu Hatieganu Univ Med & Pharm, Med Dept 2, Cluj Napoca, Romania

[18] Cent Univ Venezuela, Loira Med Ctr, Caracas, Venezuela

[19] Villa dei Pini Home Care, Serv Digest Endoscopy, Civitanova Marche, Macerata, Italy

[20] Santa Maria Goretti Hosp, Digest Endoscopy Unit, Latina, Italy

[21] ULSS7 Alto Vicentino, Digest Endoscopy Unit, Santorso, Vicenza, Italy

[22] S Giovanni Addolorata Hosp, Div Gastroenterol & Digest Endoscopy, Rome, Italy

[23] Saarland Univ, Dept Med 2, Med Ctr, Homburg, Germany

[24] Hannover Med Sch MHH, Hlth Sci, Hannover, Germany

[25] Univ Aquila, San Salvatore Hosp, Dept Life Hlth & Environm Sci, Div Gastroenterol Hepatol & Nutr, Laquila, Italy

[26] L Sacco Univ Hosp, Div Gastroenterol, Milan, Italy

[27] Federici II Univ Hosp, Dept Clin Med & Surg, Div Gastroenterol & Hepatol, Naples, Italy

[28] Sao Jose Home Care, Dept Anorectal Physiol, Rio De Janeiro, Brazil

[29] Univ Fed Goias, Dept Colorectal Surg, Goiania, GO, Brazil

[30] Catholic Univ, IRCCS A Gemelli Hosp, Fdn Policlin Gemelli, Div Internal Med & Gastroenterol, Rome, Italy

[31] Kings Coll Hosp London, Dept Colorectal Surg, London, England

[32] Maria Sklodowska Curie Natl Res Inst Oncol, Ctr Postgrad Med Educ, Dept Gastroenterol Hepatol & Clin Oncol, Warsaw, Poland

[33] Sapienza Univ, Umberto I Univ Hosp, Div Gen Surg 1, Rome, Italy

[34] Vilnius Univ Hosp, Inst Clin Med, Vilnius, Lithuania

[35] Valle dItria Hosp, Digest Endoscopy Unit, Martina Franca, Taranto, Italy

[36] Pugliese Ciaccio Hosp, Div Gastroenterol, Catanzaro, Italy

[37] Digest Endoscopy Unit, Altamura, Bari, Italy

[38] Bucchieri La Ferla Hosp, Div Gastroenterol & Digest Endoscopy, Palermo, Italy

[39] Belcolle Hosp, Div Gastroenterol, Viterbo, Italy

[40] Nuovo Regina Margherita Terr Hosp, Div Gastroenterol, Rome, Italy

[41] Sapienza Univ Rome, Dept Surg, Polo Pontino, Terracina, Latina, Italy

[42] IRCCS Osped San Raffaele, Gastroenterol & Endoscopy, Milan, Italy

[43] Univ Vita Salute San Raffaele, Milan, Italy

来源：

UNITED EUROPEAN GASTROENTEROLOGY JOURNAL | 2023年 / 11卷 / 07期

关键词：

acute diverticulitis; CODA score; DICA score; diverticular disease; diverticulosis; fecal calprotectin; SIGNIFICANT INTEROBSERVER AGREEMENT; DICA ENDOSCOPIC CLASSIFICATION; BOWEL-DISEASE; COLON SHOWS; COLONOSCOPY; DIAGNOSIS;

D O I：

10.1002/ueg2.12369

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background and AimsThe Diverticular Inflammation and Complication Assessment (DICA) classification and the Combined Overview on Diverticular Assessment (CODA) were found to be effective in predicting the outcomes of Diverticular Disease (DD). We ascertain whether fecal calprotectin (FC) can further aid in improving risk stratification. MethodsA three-year international, multicentre, prospective cohort study was conducted involving 43 Gastroenterology and Endoscopy centres. Survival methods for censored observations were used to estimate the risk of acute diverticulitis (AD) in newly diagnosed DD patients according to basal FC, DICA, and CODA. The net benefit of management strategies based on DICA, CODA and FC in addition to CODA was assessed with decision curve analysis, which incorporates the harms and benefits of using a prognostic model for clinical decisions. ResultsAt the first diagnosis of diverticulosis/DD, 871 participants underwent FC measurement. FC was associated with the risk of AD at 3 years (HR per each base 10 logarithm increase: 3.29; 95% confidence interval, 2.13-5.10) and showed moderate discrimination (c-statistic: 0.685; 0.614-0.756). DICA and CODA were more accurate predictors of AD than FC. However, FC showed high discrimination capacity to predict AD at 3 months, which was not maintained at longer follow-up times. The decision curve analysis comparing the combination of FC and CODA with CODA alone did not clearly indicate a larger net benefit of one strategy over the other. ConclusionsFC measurement could be used as a complementary tool to assess the immediate risk of AD. In all other cases, treatment strategies based on the CODA score alone should be recommended.

引用

页码：642 / 653

页数：12

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