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Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study.

ABSTRACT: Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification has been recently developed for patients suffering from diverticulosis and diverticular disease.We assessed retrospectively the predictive value of DICA in patients for whom endoscopic data and clinical follow-up were available.For each patient, we recorded: age, severity of DICA, presence of abdominal pain, C-reactive protein and faecal calprotectin test (if available) at the time of diagnosis; months of follow-up; therapy taken during the follow-up to maintain remission (if any); occurrence/recurrence of diverticulitis; need of surgery.We enrolled 1651 patients (793?M, 858?F, mean age 66.6?±?11.1 years): 939 (56.9%) patients were classified as DICA 1, 501 (30.3%) patients as DICA 2 and 211 (12.8%) patients as DICA 3. The median follow-up was 24 (9-38) months. Acute diverticulitis (AD) occurred/recurred in 263 (15.9%) patients; surgery was necessary in 57 (21.7%) cases. DICA was the only factor significantly associated to the occurrence/recurrence of diverticulitis and surgery either at univariate (?(2?)=?405.029; p?

SUBMITTER: Tursi A

PROVIDER: S-EPMC4971788 | biostudies-literature | 2016 Aug

REPOSITORIES: biostudies-literature

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Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study.

Tursi Antonio A Brandimarte Giovanni G Di Mario Francesco F Annunziata Maria L ML Bafutto Mauro M Bianco Maria A MA Colucci Raffaele R Conigliaro Rita R Danese Silvio S De Bastiani Rudi R Elisei Walter W Escalante Ricardo R Faggiani Roberto R Ferrini Luciano L Forti Giacomo G Latella Giovanni G Graziani Maria G MG Oliveira Enio C EC Papa Alfredo A Penna Antonio A Portincasa Piero P Søreide Kjetil K Spadaccini Antonio A Usai Paolo P Bonovas Stefanos S Scarpignato Carmelo C Picchio Marcello M Lecca Piera G PG Zampaletta Costantino C Cassieri Claudio C Damiani Alberto A Desserud Kari F KF Fiorella Serafina S Landi Rosario R Goni Elisabetta E Lai Maria A MA Pigò Flavia F Rotondano Gianluca G Schiaccianoce Giuseppe G

United European gastroenterology journal 20151113 4

<h4>Background</h4>Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification has been recently developed for patients suffering from diverticulosis and diverticular disease.<h4>Aims</h4>We assessed retrospectively the predictive value of DICA in patients for whom endoscopic data and clinical follow-up were available.<h4>Methods</h4>For each patient, we recorded: age, severity of DICA, presence of abdominal pain, C-reactive protein and faecal calprotectin test (if ava ...[more]

PMID: 27536372

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Project description:BackgroundThe Oxford classification of IgA nephropathy (IgAN) was revised in 2016 which lacked sufficient evidence for prognostic value of subclassification of focal segmental glomerular sclerosis (S lesion), and the proper proportion of S lesion for subclassification remains undetermined.AimThis study aimed to explore the predictive value of the new subclassification of S score on renal outcomes of IgAN patients.Methods348 patients with IgAN-associated S lesion were enrolled. According to the optimal cut-off of 25% established by receiver operating characteristic (ROC) curves, we divided S1 patients into two groups: S1a group (S lesion < 25%) and S1b group (S lesion ≥ 25%). IgAN patients with mild lesion (M0E0S0T0C0) were set as the control group. The clinical features at renal biopsy, pathological findings, and follow-up parameters (follow-up time ranged from 1 to 5 years) were collected. We used univariate and multivariate analyses to assess whether the subclassification of S score could refine risk prediction and clinical utility.ResultsWe demonstrated that S lesion ≥ 25% was associated with a more rapid GFR loss and a lower rate of complete remission of proteinuria even adjusted for multiple clinic pathological variables, compared to S1a group (All p values <.05). And the ratio of glomeruli with T lesion and crescents were higher in patients with S lesion ≥ 25%. Data showed that IgAN patients with S lesion ≥ 25% were at an increased risk of poor renal outcomes even with immunosuppression.ConclusionThis study might recommend new subclassification of S scores (S0 (no S lesion), S1 (S lesion <25% of glomeruli), and S2 (S lesion ≥ 25% of glomeruli)) for the Oxford classification. This model may also help to evaluate pros and cons of immunosuppressive therapy in IgAN patients with different level of S lesion.KEY MESSAGESS lesion ≥ 25% is an independent risk factor for poor renal outcome in IgAN patients.This new subclassification of S scores may help to evaluate pros and cons of immunotherapy in IgAN patients with different level of S lesion.

Dataset Information

Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study.

Publications

Predictive value of the Diverticular Inflammation and Complication Assessment (DICA) endoscopic classification on the outcome of diverticular disease of the colon: An international study.

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