Recurrence of Colonic Diverticulitis: Identifying Predictive CT                    Findings—Retrospective Cohort Study

Abstract BackgroundClinically occult cervical spine (CS) injuries are well described in blunt trauma, however delay in identifying these injuries and clearing the CS can result in morbidity. Our study examines the ground level fall (GLF) population to analyze whether computed tomography (CT) alone can rule out unstable injury in this group with lower force mechanism.MethodsThis is a single center, retrospective cohort study. Cases of GLF between 6/1/2012 through 12/31/2019 were queried. Characteristics of GLF and non-GLF patients were compared. Significance for categorical data was calculated with Chi Square, Student’s t-test for continuous data, and Mann-Whitney U test for ordinal data. CT negative CS injuries were identified. Binary classification tests were calculated for the ability of CT to identify CS injury using a generalized linear regression model with binomial distribution and identity link.Results69 (2.0%) of patients had CS injury without acute CT abnormality. Of these, 11 (0.3%) required surgery and were considered unstable. All patients who required surgery had a neurologic deficit. Negative predictive value (NPV) of CT for unstable CS injury was 99.7%. The combination of acute CT findings and neurologic deficit ruled out unstable CS injury with 100% NPV.ConclusionIn the GLF population, CT alone rules out unstable CS injury with high, but not perfect NPV. The combination of absence of acute CT findings and acute neurologic deficits rules out unstable CS injury with 100% NPV.

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Colonic diverticulitis in chemotherapy patients: Should operative indications change? A retrospective cohort study

International Journal of Surgery ◽

10.1016/j.ijsu.2014.10.032 ◽

2014 ◽

Vol 12 (12) ◽

pp. 1489-1494 ◽

Cited By ~ 9

Author(s):

Tushar Samdani ◽

Fredric M. Pieracci ◽

Soumitra R. Eachempati ◽

Jaime Benarroch-Gampel ◽

Alex Weiss ◽

...

Keyword(s):

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Colonic Diverticulitis ◽

Operative Indications ◽

Chemotherapy Patients

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Characteristic chest CT findings for progressive cavities in Mycobacterium avium complex pulmonary disease: a retrospective cohort study

Respiratory Research ◽

10.1186/s12931-020-1273-x ◽

2020 ◽

Vol 21 (1) ◽

Author(s):

Yohei Oshitani ◽

Seigo Kitada ◽

Ryuya Edahiro ◽

Kazuyuki Tsujino ◽

Hiroyuki Kagawa ◽

...

Keyword(s):

Cohort Study ◽

Respiratory Failure ◽

Disease Progression ◽

Pulmonary Disease ◽

Mycobacterium Avium ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Internal Diameter ◽

Ct Findings ◽

Progressive Group

Abstract Background Although cavities are an important finding in Mycobacterium avium complex pulmonary disease (MAC-PD), there is little information regarding the types of cavities that indicate disease progression. This study was performed to identify cavity characteristics that were associated with disease progression in patients with MAC-PD. Methods This retrospective cohort study included 97 patients presenting with MAC-PD with cavities between December 2006 and June 2016. We compared initial and final computed tomography (CT) findings, classified 52 and 45 patients in the progressive and non-progressive cavity groups, respectively, and examined the progression-related imaging features in initial CT images. A progressive cavity was defined by more than two-fold increase in internal diameter or emergence of a new cavity around the initial cavity. Results Patients in the progressive group were older (p < 0.001), had a lower body mass index (p = 0.043), and showed higher diabetes complication rates (p = 0.005). The initial CT in the progressive group showed a longer maximum internal diameter of the cavity (p < 0.001) and higher rates of cavities close to the chest wall (p < 0.001), multiple cavities (p = 0.023), consolidation around the cavity (p < 0.001), atelectasis (p = 0.011), and pleural thickening (p < 0.001). Multivariable logistic regression analysis revealed that the maximum internal diameter of the cavity (odds ratio [OR]: 1.11, 95% confidence interval [CI]: 1.02–1.21; p=0.012) and consolidation around the cavity (OR: 16.15, 95% CI: 4.05–64.46; p < 0.001) were significantly associated with progressive cavities. In cavities with a maximum internal diameter of ≥10 mm and simultaneous consolidation, the probability of progression was as high as 96.2%. The 10-year mortality rates in the progressive and non-progressive cavity groups were 46.7 and 9.8% (p < 0.001), respectively, while the 10-year respiratory failure rates were 28.1 and 0%, respectively (p < 0.001). Conclusions Large cavity size and consolidation on CT showed strong relationships with disease progression, which led to respiratory failure and high mortality rate.

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