肠蠕动改变可预测憩室疾病的严重程度和急性憩室炎的风险：一项前瞻性国际研究。

IF 3.4 Q2 GASTROENTEROLOGY & HEPATOLOGY

Intestinal Research Pub Date : 2024-08-12 DOI:10.5217/ir.2024.00046

Antonio Tursi, Daniele Piovani, Giovanni Brandimarte, Francesco Di Mario, Walter Elisei, Marcello Picchio, Gisella Figlioli, Gabrio Bassotti, Leonardo Allegretta, Maria Laura Annunziata, Mauro Bafutto, Maria Antonia Bianco, Raffaele Colucci, Rita Conigliaro, Dan L Dumitrascu, Ricardo Escalante, Luciano Ferrini, Giacomo Forti, Marilisa Franceschi, Maria Giovanna Graziani, Frank Lammert, Giovanni Latella, Daniele Lisi, Giovanni Maconi, Debora Compare, Gerardo Nardone, Lucia Camara de Castro Oliveira, Chaves Oliveira Enio, Savvas Papagrigoriadis, Anna Pietrzak, Stefano Pontone, Ieva Stundiene, Tomas Poškus, Giuseppe Pranzo, Matthias Christian Reichert, Stefano Rodino, Jaroslaw Regula, Giuseppe Scaccianoce, Franco Scaldaferri, Roberto Vassallo, Costantino Zampaletta, Angelo Zullo, Erasmo Spaziani, Stefanos Bonovas, Alfredo Papa, Silvio Danese

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引用次数: 0

摘要

背景/目的：憩室疾病（DD）患者经常排便异常。然而，这些改变的实体是否与 DD 的严重程度相关尚不清楚。我们旨在根据憩室炎症和并发症评估（DICA）分类、憩室评估综合概述（CODA）评分和粪便钙蛋白（FC）评估排便习惯及其与 DD 严重程度的关系：在 43 个中心开展了一项国际多中心前瞻性队列研究。采用 10 分视觉模拟量表（VAS）评估便秘和腹泻的严重程度。便秘和腹泻与 DICA 分级、CODA 评分和基础 FC 的关系采用非参数检验进行测试。在为期3年的随访过程中，采用了删减观测值的生存方法来检验便秘和腹泻与急性憩室炎发病率的关系：研究共纳入了 871 名 DD 患者。其中，分别有 208 人（23.9%）和 199 人（22.9%）在基线时报告便秘和腹泻的 VAS 评分至少为 3 分。便秘和腹泻评分越高，DICA 分级、CODA 评分和基础 FC 越高（P< 0.001）。便秘和腹泻评分与急性憩室炎发病风险增加独立相关（危险比[HR]便秘每增加1个VAS点=1.15，95%置信区间[CI]，1.04-1.27；P=0.004；HR腹泻=1.14；95%置信区间[CI]，1.03-1.26；P=0.014）：在新确诊的DD患者中，较高的DD严重程度内镜评分和综合评分与较高的便秘和腹泻基线评分相关。便秘和腹泻都是急性憩室炎的独立预后因素。

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Bowel movement alterations predict the severity of diverticular disease and the risk of acute diverticulitis: a prospective, international st.

Background/aims: Patients with diverticular disease (DD) frequently have abnormal bowel movements. However, it is unknown whether the entity of these alterations is associated with the severity of DD. We aimed to assess bowel habits and their relationship with the severity of DD according to Diverticular Inflammation and Complication Assessment (DICA) classification, Combined Overview on Diverticular Assessment (CODA) score, and fecal calprotectin (FC).

Methods: An international, multicenter, prospective cohort study was conducted in 43 centers. A 10-point visual analog scale (VAS) was used to assess the severity of constipation and diarrhea. The association of constipation and diarrhea with DICA classification, CODA score, and basal FC was tested using non-parametric tests. Survival methods for censored observations were applied to test the association of constipation and diarrhea with the incidence of acute diverticulitis over a 3-year follow-up.

Results: Of 871 patients with DD were included in the study. Of these, 208 (23.9%) and 199 (22.9%) reported a VAS score for constipation and diarrhea at least 3 at baseline, respectively. Higher constipation and diarrhea scores were associated with increasing DICA classification, CODA score and basal FC (P< 0.001). Constipation and diarrhea scores were independently associated with an increased hazard of developing acute diverticulitis (hazard ratio [HR]constipation = 1.15 per 1-VAS point increase, 95% confidence interval [CI], 1.04-1.27; P=0.004; and HRdiarrhea =1.14; 95% CI, 1.03-1.26; P=0.014, respectively).

Conclusions: In newly diagnosed patients with DD, higher endoscopic and combined scores of DD severity were associated with higher scores of constipation and diarrhea at baseline. Both constipation and diarrhea were independent prognostic factors of acute diverticulitis.

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来源期刊

Intestinal Research GASTROENTEROLOGY & HEPATOLOGY-

CiteScore

7.40

自引率

10.20%

发文量

审稿时长

38 weeks

期刊介绍： Intestinal Research (Intest Res) is the joint official publication of the Asian Organization for Crohn''s and Colitis (AOCC), Chinese Society of IBD (CSIBD), Japanese Society for IBD (JSIBD), Korean Association for the Study of Intestinal Diseases (KASID), Taiwan Society of IBD (TSIBD) and Colitis Crohn''s Foundation (India) (CCF, india). The aim of the Journal is to provide broad and in-depth analysis of intestinal diseases, especially inflammatory bowel disease, which shows increasing tendency and significance. As a Journal specialized in clinical and translational research in gastroenterology, it encompasses multiple aspects of diseases originated from the small and large intestines. The Journal also seeks to propagate and exchange useful innovations, both in ideas and in practice, within the research community. As a mode of scholarly communication, it encourages scientific investigation through the rigorous peer-review system and constitutes a qualified and continual platform for sharing studies of researchers and practitioners. Specifically, the Journal presents up-to-date coverage of medical researches on the physiology, epidemiology, pathophysiology, clinical presentations, and therapeutic interventions of the intestinal diseases. General topics of interest include inflammatory bowel disease, colon and small intestine cancer or polyp, endoscopy, irritable bowel syndrome and other motility disorders, infectious enterocolitis, intestinal tuberculosis, and so forth. The Journal publishes diverse types of academic materials such as editorials, clinical and basic reviews, original articles, case reports, letters to the editor, brief communications, perspective, statement or commentary, and images that are useful to clinicians and researchers.