C-reactive protein as a marker of complicated diverticulitis in patients on anti-inflammatory medications.

Abstract

BACKGROUND:

Diverticulitis is a common indication for surgical emergency room admission, often leading to abdominal computed tomography (CT) scanning for both diagnosis and staging. C-reactive protein (CRP) has been identified as a useful biomarker of inflammation. Aspirin and corticosteroids are known to down-regulate CRP production. In this study, we evaluated the usefulness of CRP as a biomarker for complicated diverticulitis and specifically in patients on anti-inflammatory medications: aspirin and corticosteroids.

METHODS:

We analyzed the medical records of patients diagnosed at one medical center during a two-year period, with left-sided diverticulitis, according to clinical data and CT scan. Disease severity was assessed by the Hinchey score using the radiological findings detected by CT.

RESULTS:

A total of 295 patients were included in the study. Two hundred and forty-three (82 %) were classified with uncomplicated (Hinchey 1a) and 52 (18 %) with complicated disease (Hinchey > 1a). Mean CRP levels were 133.5 and 63.5 mg/ml for those with complicated and uncomplicated disease, respectively (p < 0.001), and 139 and 60 mg/ml, respectively (p < 0.001) in the subgroup of patients taking aspirin (n = 61). For 14 patients on corticosteroid treatment, the difference in mean CRP levels for complicated and uncomplicated disease was not statistically significant. CRP > 90 mg/ml had 88 % sensitivity and 75 % specificity for complicated disease.

CONCLUSIONS:

The CRP level distinguished between complicated and uncomplicated disease among left-sided diverticulitis patients including those taking aspirin, but not among those on corticosteroid treatment.

• Authors: E Nizri, S Spring, A Ben-Yehuda, M Khatib, J Klausner, R Greenberg
• Journal: Techniques in coloproctology (Tech Coloproctol) Vol. 18 Issue 2 Pg. 145-9 (Feb 2014) ISSN: 1128-045X [Electronic] Italy
• PMID: 23807310 (Publication Type: Journal Article)

Chemical References

• Adrenal Cortex Hormones
• Anti-Inflammatory Agents, Non-Steroidal
• Biomarkers
• C-Reactive Protein
• Aspirin

Topics

• Adrenal Cortex Hormones (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Aspirin (therapeutic use)
• Biomarkers (blood)
• C-Reactive Protein (metabolism)
• Diverticulitis, Colonic (blood, classification, diagnostic imaging)
• Female
• Humans
• Male
• Middle Aged
• Sensitivity and Specificity
• Severity of Illness Index
• Tomography, X-Ray Computed