Format

Send to

Choose Destination
Int J Colorectal Dis. 2017 Jan;32(1):41-47. doi: 10.1007/s00384-016-2644-0. Epub 2016 Sep 9.

Clinical diagnostic accuracy of acute colonic diverticulitis in patients admitted with acute abdominal pain, a receiver operating characteristic curve analysis.

Author information

1
Department of Surgery, Levanger Hospital, Nord-Trøndelag Hospital Trust, N-7602, Levanger, Norway.
2
Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
3
Clinic of Surgery, St Olavs Hospital, University of Trondheim, Trondheim, Norway.
4
Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
5
Regional Centre for Child and Youth Mental Health and Child Welfare - Central Norway, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.
6
Department of Surgery, Levanger Hospital, Nord-Trøndelag Hospital Trust, N-7602, Levanger, Norway. thedna@hnt.no.
7
Unit for Applied Clinical Research, Department of Cancer Research and Molecular Medicine, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway. thedna@hnt.no.

Abstract

PURPOSE:

The study investigated the capability of clinical findings, temperature, C-reactive protein (CRP), and white blood cell (WBC) count to discern patients with acute colonic diverticulitis from all other patients admitted with acute abdominal pain.

METHODS:

The probability of acute diverticulitis was assessed by the examining doctor, using a scale from 0 (zero probability) to 10 (100 % probability). Receiver operating characteristic (ROC) curves were used to assess the clinical diagnostic accuracy of acute colonic diverticulitis in patients admitted with acute abdominal pain.

RESULTS:

Of 833 patients admitted with acute abdominal pain, 95 had acute colonic diverticulitis. ROC curve analysis gave an area under the ROC curve (AUC) of 0.95 (CI 0.92 to 0.97) for ages <65 years, AUC = 0.86 (CI 0.78 to 0.93) in older patients. Separate analysis showed an AUC = 0.83 (CI 0.80 to 0.86) of CRP alone. White blood cell count and temperature were almost useless to discriminate acute colonic diverticulitis from other types of acute abdominal pain, AUC = 0.59 (CI 0.53 to 0.65) for white blood cell count and AUC = 0.57 (0.50 to 0.63) for temperature, respectively.

CONCLUSION:

This prospective study demonstrates that standard clinical evaluation by non-specialist doctors based on history, physical examination, and initial blood tests on admission provides a high degree of diagnostic precision in patients with acute colonic diverticulitis.

KEYWORDS:

Acute colonic diverticulitis; C-reactive protein; Clinical diagnostic accuracy; Receiver operating characteristic curve; Temperature; White blood cell count

PMID:
27613727
PMCID:
PMC5219887
DOI:
10.1007/s00384-016-2644-0
[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center