RT Journal Article
T1 Outcomes of initially nonoperative management of diverticulits with abscess formation in inmunosuppressed patients. DIPLICAB study COLLABORATIVE group
A1 Ocaña, Juan
A1 Labalde Martínez, María
A1 Dujovne, Paula
A1 Die, Javier
AB Aim: Management of diverticulitis with abscess formation in immunosuppressed patients(IMS) remains unclear. The main objective of the study was to assess short- and long-termoutcomes between IMS and immunocompetent patients (IC). The secondary aim was toidentify risk factors for emergency surgery.Methods: A nationwide retrospective cohort study was performed at 29 Spanish referralcentres between 2015–2019 including consecutive patients with first episode of diverticulitisclassified as modified Hinchey Ib or II. IMS included immunosuppressive therapy,biologic therapy, malignant neoplasm with active chemotherapy and chronic steroidtherapy. A multivariate analysis was performed to identify independent risk factors toemergency surgery in IMS.Results: A total of 1395 patients were included; 118 IMS and 1277 IC. There were nosignificant differences in emergency surgery between IMS and IC (19.5% and 13.5%,p = 0.075) but IMS was associated with higher mortality (15.1% vs. 0.6%, p < 0.001). Similarrecurrent episodes were found between IMS and IC (28% vs. 28.2%, p = 0.963). Followingmultivariate analysis, immunosuppressive treatment, p = 0.002; OR: 3.35 (1.57–7.15), freegas bubbles, p < 0.001; OR: 2.91 (2.01–4.21), Hinchey II, p = 0.002; OR: 1.88 (1.26–2.83),use of morphine, p < 0.001; OR: 3.08 (1.98–4.80), abscess size ≥5 cm, p = 0.001; OR: 1.97(1.33–2.93) and leucocytosis at third day, p < 0.001; OR: 1.001 (1.001–1.002) were independentlyassociated with emergency surgery in IMS.Conclusion: Nonoperative management in IMS has been shown to be safe with similartreatment failure than IC. IMS presented higher mortality in emergency surgery andsimilar rate of recurrent diverticulitis than IC. Identifying risk factors to emergency surgerymay anticipate emergency surgery.
PB Wiley
SN 1462-8910
YR 2023
FD 2023-09-22
LK https://hdl.handle.net/20.500.14352/98887
UL https://hdl.handle.net/20.500.14352/98887
LA eng
NO Ocaña J, García-Pérez JC, Fernández-Martínez D, Aguirre I, Pascual I, Lora P, Espin-Basany E, Labalde-Martínez M, León C, Pastor-Peinado P, López-Domínguez C, Muñoz-Plaza N, Valle A, Dujovne P, Alías D, Pérez-Santiago L, Correa A, Carmona M, Fernández-Cebrián JM, Die J; collaborators from The DIPLICAB Study Collaborative Group. Outcomes of initially nonoperative management of diverticulitis with abscess formation in immunosuppressed patients. DIPLICAB study COLLABORATIVE group. Colorectal Dis. 2024 Jan;26(1):120-129. doi: 10.1111/codi.16810. Epub 2023 Nov 27. PMID: 38010046.
DS Docta Complutense
RD 11 abr 2025