| Contributors: |
Alsourani, Adnan; Pastor, Carlo; Arredondo, Jorge; Colombari, Renan Carlo; Pellino, Gianluca; Tejedor, Patricia; Abate; Emmanuele (Vittorio Emanuele III, Hospital; Carate Brianza, (MB); Trapani; Italy) Aguilar, Frasco; Jorge Luis (Insti- tuto Nacional de Ciencias Médicas, Y Nutrición Salvador Zubirán; Mexico, City; Mexico), Aizza; Giada (Cattinara University, Hospital; Trieste; Italy) Alonso, Hernández; Natalia (Hospital Universitario Son, Espase; Mallorca; Spain) Alonso, Poza; Alfredo (Hospital Universi- tario del, Sureste; Arganda Del, Rey; Madrid; Spain) Alvarellos, Pérez; Alicia (Clínica Universidad de, Navarra; Madrid, Y Pamplona; Spain), Annichiarico; Alfredo (Azienda Ospedaliero-Universitaria di, Parma; Italy), Arredondo; Jorge (Complejo Hospitalario Universitario de, León; León; Spain), Arru; Giaime Gonario (Hospital San, Raffaele; Milan; Italy) Asensio, Gómez; Luis (Hospital Universitario La, Paz; Spain), Atif; Qurrat Al Ain (Dartford and Gravesham NHS Trust) Avel-, Laneda; Nicolas (Hospital Universitario, Cemic; Buenos, Aire; Argen- tina), Barletta; Giuseppe (Clinica San, Michele; Caserta; Italy) Bian-, Chini; Matteo (Ospedale, Versilia; Azienda Usl Toscana, Nord-Ovest; Lido Di Camaiore, (LU); Italy), Biloslavo; Alan (Cattinara University, Hospital; Italy) Bollo, Rodríguez; Jesús (Hospital de la Santa Creu, I Sant Pau; Barcelona; Spain), Bosch-Ramírez; Marina (Hospital General Universitario de, Elche; Alicante; Spain), Brachini; Gioia (Poli- clinico Umberto I—Sapienza University of, Rome; Italy), Burati; Morena (Hospital Alessandro, Manzoni; Lecco; Italy), Byrne; James (Cork University, Hospital; Ireland), Cagiga; Carmen (Hospital Uni- versitario Marqués de, Valdecilla; Santander; Spain) Caiña, Ruiz; Rubén (Hospital Universitario Marqués de, Valdecilla; Spain) Cam-, Panelli; Michela (University of Roma Tor, Vergata; Emergency Surgery, Department; Rome; Italy) Cano, Pecharromán; Esther María (Hospital General Universitario Ntra Sra del, Prado; Talavera De La Reina, (Toledo); Spain), Carrie; Augusto (Hospital Universitario, Cemic; Bue- nos, Aire; Argentina) Castro, Suárez; Marta; Catena, Fausto; Cazarez-Huazano; Sinue (North Central Hospital, Pemex; Mexico), Chiarugi; Massimo, (General; Emergency And Trauma, Surgery; Pisa University, Hospital; Italy), Cicuttin; Enrico, (General; Emergency and Trauma Sur-, Gery; Italy), Cillara; Nicola (UOC General Surgery Santissima Trinità, Hospital; Asl, Cagliari; Italy), Clerici; Fed- erico (General and Emergency, Surgery; Asst Valle, Olona |
| Description: |
The objective of this study was to examine the differences in clinical presentation and complications during the first year of follow-up in patients who experienced an episode of acute diverticulitis (AD) with pericolic free gas, comparing outcomes across different age groups. A prospective subanalysis was conducted on a cohort from the ADiFAS study, which originally included 1099 patients. After excluding 289 patients who did not meet the inclusion criteria, 810 patients remained for analysis. From this cohort, 330 patients with AD and pericolic free gas were selected using propensity score matching and divided into two age groups: < 65years and ≥ 65years. The groups were matched based on sex, BMI, diabetes mellitus (DM), cardiovascular disease, previous episodes of AD, and the presence of free fluid on CT scan. Data were assessed for Hinchey classification, surgical procedures, complications, and the frequency of surveillance through colonoscopy and CT scans. The study found a significantly higher rate of surgery in the older group during the index episode (17% vs. 4.2%, p = 0.000). A higher proportion of patients in the older group were misclassified as Hinchey II (18.2% vs. 6.4%, p = 0.007) and Hinchey III (2.3% vs. 0.7%, p = 0.304). All patients classified as Hinchey III (1 in the younger group and 3 in the older group) underwent emergency surgery. In the younger group, 2 out of 8 emergency surgeries were for patients classified as Hinchey II, compared to 11 out of 28 in the older group. Only 58% of patients underwent any form of imaging or endoscopic surveillance during the first year of follow-up. Among those, complications such as abscess, fistula, or stenosis were observed in 17% of patients, occurring more frequently in the older group (16.9% vs. 5.7%, p = 0.089). Nearly 50% of these patients required surgery, with 6 cases in the younger group and 9 in the older group. Emergency surgeries were more common in the older group (2.4% vs. 0.6%, p = 0.186), as was elective surgery (10.3% vs. 7.9%, p = ... |