SP 10.10 Can CRP Concentration Predict Likely Outcome in Patients with Hinchey Type I Diverticulitis who were Conservatively Managed with Antibiotics?
Ashwarya Verma, Sophie Baird, Josh McGovern, James KynastonAbstract
Aims
The aim of the following study was to examine if CRP concentration could predict likely outcome in patients with Hinchey type I diverticulitis who were conservatively managed with antibiotics.
Methods
Consecutive patients who were conservatively managed with antibiotics for Hinchey type IA or IB diverticulitis at our Trust, between January 2021 - July 2025 from a prospectively maintained database. Peak CRP during admission and that on discharge were gathered. CRP concentrations were categorized as <150/≥150mg/L. Outcomes of interest; 90-day re-admission and re-admission requiring further management (radiological drainage or surgery).
Results
Seventy patients were included. 31% (n=22) were older than 65years and 54%(n=38) were male. The median peak CRP concentration was 231mg/L(135-347). The median discharge CRP concentration was 85mg/L (38-132) and 21% (n=15) had a CRP /≥150mg/L. 20%(n=14) were readmitted within 90 days with 35% (n=5) requiring further management. Out of these, one patient was managed with a drain and four underwent surgery. Between patients who were discharged successfully and readmitted within 90-day, there was no significant difference in the median length of antibiotic therapy (10 vs 10, p=0.994) or median peak CRP concentration (225 vs 264, p=0.391) however, length of stay (4 vs 8, p=0.002) was significant.
Conclusion
Neither peak or discharge CRP concentration of >150mg/L was associated with 90-day re-admission or the need for further management in patients with Hinchey type I diverticulitis managed conservatively with antibiotics. The magnitude of systemic inflammatory response in isolation does not appear to be an isolated determinant of outcome.