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The role of quantitative radiological measures of visceral adiposity in diverticulitis.

Authors
  • Ng, Zi Qin1
  • Wijesuriya, Ruwan2, 3
  • Misur, Philip4
  • Tan, Jih Huei5
  • Moe, Kyaw Soe2
  • Theophilus, Mary2, 6
  • 1 Department of General Surgery, St John of God Midland Hospital, 1 Clayton Street, Midland, WA, 6056, Australia. [email protected] , (Australia)
  • 2 Department of General Surgery, St John of God Midland Hospital, 1 Clayton Street, Midland, WA, 6056, Australia. , (Australia)
  • 3 School of Medicine, University of Notre Dame, Fremantle, WA, Australia. , (Australia)
  • 4 Perth Radiological Clinic, St John of God Midland Hospital, Midland, WA, Australia. , (Australia)
  • 5 Department of General Surgery, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia. , (Malaysia)
  • 6 Curtin Medical School, Curtin University, Bentley, WA, Australia. , (Australia)
Type
Published Article
Journal
Surgical Endoscopy
Publisher
Springer-Verlag
Publication Date
Feb 01, 2021
Volume
35
Issue
2
Pages
636–643
Identifiers
DOI: 10.1007/s00464-020-07427-5
PMID: 32072285
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

Diverticular disease has been linked to obesity. Recent studies have assessed the role of visceral adiposity with diverticulitis and its complications. The aim of this study was to evaluate the association of quantitative radiological measures of visceral adiposity in patients with diverticulitis with vital signs, biochemistry results, uncomplicated versus complicated diverticulitis and its interventions. A retrospective analysis of all patients with diverticulitis admitted from November 2015 to April 2018 at a single institution was performed. Data collected included demographics, vital signs, biochemistry results, CT scan findings and management outcomes. The patients were divided into uncomplicated (U) and complicated diverticulitis (C) groups. Visceral fat area (VFA), subcutaneous fat area (SFA) and VFA/SFA ratio (V/S) were measured at L4/L5 level by the radiologist. Statistical analysis was performed to evaluate the association of VFA, SFA, V/S with the parameters in both U and C groups. 352 patients were included in this study (U:C = 265:87). There was no significant difference in vital signs and biochemistry results in both groups. There was no significant difference in VFA, SFA, V/S ratios in both groups. In patients with V/S ratio > 0.4, they were 5.06 times more likely to undergo emergency intervention (95% CI 1.10-23.45) (p = 0.03). On multivariate analysis, a heart rate > 100 (OR 2.9, 95% CI 1.2-6.7), CRP > 50 (OR 3.4, 95% CI 1.9-6.0), WCC < 4 or > 12 (OR 2.1, 95% CI 1.2-3.6) and V/S ratio > 0.4 (OR 2.8, 95% CI 1.5-5.4) were predictive of complicated diverticulitis. The quantitative radiological measurement of visceral adiposity is useful in prognostication in patients presenting with diverticulitis.

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