| Title: |
Diagnostic Utility of Prognostic Nutritional Index, Systemic Immune-Inflammation Index and Related Indices for Hinchey-Based Severity Stratification in Acute Diverticulitis: A Retrospective Cross-Sectional Study |
| Authors: |
Keyif, MF; Bolat, F; Sit, M; Ozer, B; Catal, O; Erkol, MH |
| Source: |
Nigerian Journal of Clinical Practice ; volume 28, issue 12, page 1457-1463 ; ISSN 1119-3077 2229-7731 |
| Publisher Information: |
Ovid Technologies (Wolters Kluwer Health) |
| Publication Year: |
2025 |
| Description: |
Background: Acute diverticulitis is a common gastrointestinal emergency with a wide spectrum of clinical severity. The Hinchey classification, based on abdominal computed tomography (CT), remains the gold standard for staging, but timely imaging may not always be feasible in resource-limited or emergency settings. In this context, blood-derived indices may serve as useful adjuncts for early risk stratification. Aim: This study aimed to evaluate the diagnostic utility of inflammatory and nutritional indices—including the prognostic nutritional index (PNI), systemic immune-inflammation index (SII), inflammatory prognostic index (IPI), C-reactive protein-to-albumin ratio (CAR), and CRP–albumin–lymphocyte index (CALLY)—in predicting disease severity according to the Hinchey classification. Methods: In this retrospective cross-sectional study, 64 patients diagnosed with acute diverticulitis between 2014 and 2024 were included. All patients underwent CT-based staging and laboratory testing on admission. Receiver operating characteristic (ROC) curve analyses were performed to assess the diagnostic performance of each index across Hinchey stages 1a to 4. Results: PNI showed the highest accuracy in predicting Hinchey 1a [area under the curve (AUC) = 0.778, sensitivity = 80 %, specificity = 66 %]. SII demonstrated excellent performance in identifying stage 4 (AUC = 0.935), while IPI was most effective in stage 3 (AUC = 0.945). CAR and CALLY showed moderate diagnostic value in later stages. Conclusion: PNI and SII may serve as practical and cost-effective tools for staging acute diverticulitis when imaging is delayed. These indices may assist in early clinical decision-making, especially in emergency and low-resource settings. |
| Document Type: |
article in journal/newspaper |
| Language: |
English |
| DOI: |
10.4103/njcp.njcp_411_25 |
| Availability: |
https://doi.org/10.4103/njcp.njcp_411_25; https://journals.lww.com/10.4103/njcp.njcp_411_25 |
| Rights: |
https://creativecommons.org/licenses/by-nc-nd/4.0/ |
| Accession Number: |
edsbas.56CDDAD |
| Database: |
BASE |