Neutrophil to Lymphocyte Ratio as a Predictor of Complicated Acute Diverticulitis

NCT04663490 | Completed

• 1 other identifier: 0717040
• Study Type: observational
• Target: 325
• Locations: 1 country
• Sites: 1

Brief Summary

Introduction: Various biomarkers have been studied to predict the severity of acute diverticulitis (AD), such as the leukocyte count and CRP, which are useful but lack sufficient sensitivity. The neutrophil-lymphocyte ratio (NLR) has been identified as a new inflammatory biomarker in several abdominal pathologies. However, few studies determine its association with the severity of AD. The objective of the present study was to determine the utility and diagnostic precision of NLR in complicated acute diverticulitis (cAD). Material and methods: Descriptive, retrospective and analytical study. Patients older than 18 years with a diagnosis of AD were included, from 2013 - 2018. Demographic variables, days of hospitalization, leukocyte count, neutrophils, lymphocytes, ESR, CRP, and NLR were analyzed. The sensitivity and specificity for the diagnosis of cAD were determined using ROC curves.

Conditions

Acute Diverticulitis

Keywords

neutrophil-to-lymphocyte ratio; C-reactive protein; biomarkers

Outcome Measures

Primary Outcomes (5)

• Demographic variables

  sex and age

  2013-2018

• inpatient stay

  days

  2013-2018

• level of severity in diverticular process

  confirmed by computed tomography

  2013-2018

• value of C-reactive protein

  normal value under 5 mg/l

  2013-2018

• value of Neutrophil to Lymphocyte Ratio

  It can be obtained from the blood count (the absolute neutrophil count divided by the absolute lymphocyte count)

  2013-2018

Study Arms (2)

simple acute diverticulitis

Ninety-one percent (n=295) were categorized as simple acute diverticulitis

Diagnostic Test: Neutrophil to Lymphocyte Ratio

complicated acute diverticulitis

9% (n=30) presented were categorized as complicated acute diverticulitis

Diagnostic Test: Neutrophil to Lymphocyte Ratio

Interventions

Neutrophil to Lymphocyte Ratio DIAGNOSTIC_TEST

Zahorec et al. identified the neutrophil-lymphocyte ratio (NLR) as an inflammation marker in critical patients, defining as the absolute neutrophil count divided by the absolute lymphocyte count

complicated acute diverticulitis; simple acute diverticulitis

Eligibility Criteria

• Age: 18 Years - 92 Years
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Probability Sample

Study Population

325 patients

You may qualify if:

• Patients older than 18 years.
• Patients with a diagnosis of acute diverticulitis confirmed by computed tomography.

You may not qualify if:

• Patients under 18 years of age.
• Patients with hematological diseases.
• Patients with extra abdominal infections.
• Patients with oncological diseases

Sponsors & Collaborators

• Clinica Universitaria Reina Fabiola, Universidad Catolica de Cordoba: lead

Study Sites (1)

Clínica Universitaria Reina Fabiola

Córdoba, 5000, Argentina

Location

Related Publications (17)

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  PMID: 21876861 BACKGROUND

• Feingold D, Steele SR, Lee S, Kaiser A, Boushey R, Buie WD, Rafferty JF. Practice parameters for the treatment of sigmoid diverticulitis. Dis Colon Rectum. 2014 Mar;57(3):284-94. doi: 10.1097/DCR.0000000000000075. No abstract available.

  PMID: 24509449 BACKGROUND

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• Bates DDB, Fernandez MB, Ponchiardi C, von Plato M, Teich JP, Narsule C, Anderson SW, Gupta A, LeBedis CA. Surgical management in acute diverticulitis and its association with multi-detector CT, modified Hinchey classification, and clinical parameters. Abdom Radiol (NY). 2018 Aug;43(8):2060-2065. doi: 10.1007/s00261-017-1422-y.

  PMID: 29204676 BACKGROUND

• Kaser SA, Fankhauser G, Glauser PM, Toia D, Maurer CA. Diagnostic value of inflammation markers in predicting perforation in acute sigmoid diverticulitis. World J Surg. 2010 Nov;34(11):2717-22. doi: 10.1007/s00268-010-0726-7.

  PMID: 20645093 BACKGROUND

• Zahorec R. Ratio of neutrophil to lymphocyte counts--rapid and simple parameter of systemic inflammation and stress in critically ill. Bratisl Lek Listy. 2001;102(1):5-14. English, Slovak.

  PMID: 11723675 BACKGROUND

• Zahorec R. Neutrophil-to-lymphocyte ratio. Sixteen-year-long history since publication of our article in Bratislava Medical Journal. Bratisl Lek Listy. 2017;118(6):321-323. doi: 10.4149/BLL_2017_062. No abstract available.

  PMID: 28664739 BACKGROUND

• Miyamoto R, Inagawa S, Sano N, Tadano S, Adachi S, Yamamoto M. The neutrophil-to-lymphocyte ratio (NLR) predicts short-term and long-term outcomes in gastric cancer patients. Eur J Surg Oncol. 2018 May;44(5):607-612. doi: 10.1016/j.ejso.2018.02.003. Epub 2018 Feb 13.

  PMID: 29478743 BACKGROUND

• Reynolds IS, Heaney RM, Khan W, Khan IZ, Waldron R, Barry K. The Utility of Neutrophil to Lymphocyte Ratio as a Predictor of Intervention in Acute Diverticulitis. Dig Surg. 2017;34(3):227-232. doi: 10.1159/000450836. Epub 2016 Dec 10.

  PMID: 27941316 BACKGROUND

• Hogan J, Sehgal R, Murphy D, O'Leary P, Coffey JC. Do Inflammatory Indices Play a Role in Distinguishing between Uncomplicated and Complicated Diverticulitis? Dig Surg. 2017;34(1):7-11. doi: 10.1159/000447250. Epub 2016 Jun 24.

  PMID: 27336407 BACKGROUND

• Zager Y, Horesh N, Dan A, Aharoni M, Khalilieh S, Cordoba M, Nevler A, Gutman M, Rosin D. Associations of novel inflammatory markers with long-term outcomes and recurrence of diverticulitis. ANZ J Surg. 2020 Oct;90(10):2041-2045. doi: 10.1111/ans.16220. Epub 2020 Aug 28.

  PMID: 32856387 BACKGROUND

• Mari A, Khoury T, Lubany A, Safadi M, Farraj M, Farah A, Kadah A, Sbeit W, Mahamid M. Neutrophil-to-Lymphocyte and Platelet-to-Lymphocyte Ratios Are Correlated with Complicated Diverticulitis and Hinchey Classification: A Simple Tool to Assess Disease Severity in the Emergency Department. Emerg Med Int. 2019 Aug 14;2019:6321060. doi: 10.1155/2019/6321060. eCollection 2019.

  PMID: 31485352 BACKGROUND

• Kang HS, Cha YS, Park KH, Hwang SO. Delta neutrophil index as a promising prognostic marker of emergent surgical intervention for acute diverticulitis in the emergency department. PLoS One. 2017 Nov 1;12(11):e0187629. doi: 10.1371/journal.pone.0187629. eCollection 2017.

  PMID: 29091955 BACKGROUND

• Agha RA, Borrelli MR, Vella-Baldacchino M, Thavayogan R, Orgill DP; STROCSS Group. The STROCSS statement: Strengthening the Reporting of Cohort Studies in Surgery. Int J Surg. 2017 Oct;46:198-202. doi: 10.1016/j.ijsu.2017.08.586. Epub 2017 Sep 7.

  PMID: 28890409 BACKGROUND

• Jeon TJ, Park JY. Clinical significance of the neutrophil-lymphocyte ratio as an early predictive marker for adverse outcomes in patients with acute pancreatitis. World J Gastroenterol. 2017 Jun 7;23(21):3883-3889. doi: 10.3748/wjg.v23.i21.3883.

  PMID: 28638228 BACKGROUND

• Bharucha AE, Parthasarathy G, Ditah I, Fletcher JG, Ewelukwa O, Pendlimari R, Yawn BP, Melton LJ, Schleck C, Zinsmeister AR. Temporal Trends in the Incidence and Natural History of Diverticulitis: A Population-Based Study. Am J Gastroenterol. 2015 Nov;110(11):1589-96. doi: 10.1038/ajg.2015.302. Epub 2015 Sep 29.

  PMID: 26416187 BACKGROUND

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: RETROSPECTIVE
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: General Surgeon

Study Record Dates

• First Submitted: November 30, 2020
• First Posted: December 11, 2020
• Study Start: January 1, 2013
• Primary Completion: January 1, 2018
• Study Completion: January 1, 2020
• Last Updated: December 11, 2020

Record last verified: 2020-12

Data Sharing

• IPD Sharing: Will not share

Locations

AR (1)