BACKGROUND: @entity298 secondary to complicated @entity4436 is a life-threatening condition; the standard treatment is surgery. Despite advances in peri-operative care, this condition is accompanied by a high peri-operative complication rate (22%-25%). No definitive evidence is available to recommend a preferred surgical technique in @entity1 with @entity5 . METHODS: A matched case-control study enrolling @entity1 from four surgical units at Italian university hospital was planned to assess the most appropriate surgical treatment on the basis of @entity1 performance status and @entity298 exposure, with the aim of minimizing the surgical site infection (SSI). A series of 1,175 @entity1 undergoing surgery for Hinchey III/IV @entity298 in 2003-2013 were analyzed. Cases (n=145) were selected from among those @entity1 who developed an SSI. THE CASE: control ratio was 1:3. Cases and control groups were matched by age, gender, body mass index, and Hinchey grade. We considered three surgical techniques: T1=Hartman's procedure; T2=sigmoid resection, @entity254 , and ileostomy; and T3=sigmoid resection and @entity254 . Six scoring systems were analyzed to assess performance status; subsequently, @entity1 were divided into low, mild, and high risk (LR, MR, HR) according to the system producing the highest area under the curve. We classified @entity298 exposition as P1=<12 h; P2=12-24 h; P3=>24   h. Univariable and multivariable analyses were performed. RESULTS: The Apgar scoring system defined the risk groups according to performance status. Lowest SSI risk was expected when applying T3 in P1 (OR=0.22), P2 (OR=0.5) for LR and in P1 (OR=0.63) for MR; T2 in P2 (OR=0.5) in LR and in P1 (OR=0.61) in MR; T1 in P3 (OR=0.56) in LR; in P2 (OR=0.63) and P3 (OR=0.54) in MR @entity1 , and in each P subgroup (OR=0.93;0.97;1.01) in HR. CONCLUSIONS: Pre-operative assessment based on Apgar scoring system integrated with @entity298 exposure in complicated @entity4436 may offer a ready-to-use tool for reducing SSI-related complications and applying appropriate treatment, reducing the need for disabling ostomy.

Influence of Surgical Technique, Performance Status, and XXXX Exposure on Surgical Site Infection in Acute Complicated Diverticulitis: A Matched Case-Control Study.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity5 :: ('MESH:D009369', 'Disease') :: ['Hinchey stage III/IV disease'] @entity254 :: ('MESH:C563598', 'Disease') :: ['anastomosis'] @entity4436 :: ('MESH:D004238', 'Disease') :: ['diverticulitis'] @entity298 :: ('MESH:D010538', 'Disease') :: ['Acute generalized peritonitis', 'peritonitis']
@entity298 :: (MESH:D010538,Disease) :: ['Peritonitis']
