eP247 - Hematological Indices as Predictive Markers in Complicated Diverticular Disease: Unraveling the Diagnostic Potential

Purpose/Background: Diverticular disease (DD) is a medical condition that can lead to severe complications necessitating surgical intervention. It is estimated that approximately 60% of individuals aged 60 and older are affected by this condition. Notably, since 2019, there has been a concerning exponential increase in the incidence of DD among young adults, reaching up to 132%. This alarming trend has spurred interest in identifying biomarkers that can predict the severity of complicated DD, facilitating early intervention and ultimately enhancing long-term patient outcomes. Hematological indices, such as the platelet-to-lymphocyte ratio (PLR) and neutrophil-to-lymphocyte ratio (NLR), have emerged as potential promising prognostic markers in various infectious and inflammatory diseases. This study aimed to evaluate the utility of hematological index as prognostic tools in complicated DD.Methods/Interventions: A cross-sectional study was conducted on 58 patients treated at the General Hospital of Mexico “Dr. Eduardo Liceaga” between March 2022 and February 2023. Clinical and demographic characteristics, comorbidities, disease severity by the modified Hinchey scale, and treatment received were recorded. Biochemical parameters, including lymphocyte, neutrophil, and platelet counts, were analyzed. Neutrophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) were calculated. Comparisons of categorical variables were performed using the chi-square test and quantitative variables using Mann-Whitney U or Student's t-test, depending on the distribution of the variables. Correlations were determined using Spearman's rank correlation coefficient. An ROC analysis was conducted to determine cutoff points and diagnostic accuracy. 2x2 contingency tables were generated to calculate odds ratios. A p-value < 0.05 was considered significant.Results/Outcomes: The clinical and demographic characteristics of the patients included in the study are described in Table 1. We found a positive correlation between the neutrophil-to-lymphocyte ratio [NLR] (r= 0.38; p= < 0.001) and the platelet-to-lymphocyte ratio [PLR] (r=0.35; p= < 0.001) and disease severity. Similarly, a cutoff point was identified for NLR of 10 (Sensitivity (S): 100%, Specificity (Sp): 74%) and for PLR of 219 (Sensitivity (S): 100%, Specificity (Sp): 71%) to discriminate between complicated and uncomplicated DD. NLR >10 (OR: 2.22 [95% CI: 1.12 – 4.37]; p=0.02) and PLR >219 (OR: 2.12 [95% CI: 1.02 – 4.39]; p=0.03) represent a risk factor for complicated DD.Conclusion/

Discussion: The use of hematological indices can be a low-cost and adequately effective parameter to determine severity in complicated DD. The INL and IPL indices can be used as prognostic markers in patients with diverticular disease. Identifying INL and IPL as risk factors and prognostic markers provides the possibility for early intervention and more effective management of patients with complicated diverticular disease, which can improve clinical outcomes and reduce the associated morbidity and mortality of this disease."Table 1. Demographic and clinical characteristics of DD patients N = 58

** Values are expressed on median and interquartile range.
ROC Curve Cohort Point

INL = 10; S: 100%, Sp 74%
IPL = 219; S 100%, Sp 71%"