Objective To investigate the predictive value of the Diverticular Inflammation and Complication Assessment (DICA) classification and to develop and validate a combined endoscopic-clinical score predicting clinical outcomes of diverticulosis, named Combined Overview on Diverticular Assessment (CODA). Design A multicentre, prospective, international cohort study. Setting 43 gastroenterology and endoscopy centres located in Europe and South America. Participants 2215 patients (2198 completing the study) at the first diagnosis of diverticulosis/diverticular disease were enrolled. Patients were scored according to DICA classifications. Interventions A 3-year follow-up was performed. Main outcome measures To predict the acute diverticulitis and the surgery according to DICA classification. Survival methods for censored observation were used to develop and validate a novel combined endoscopic-clinical score for predicting diverticulitis and surgery (CODA score). Results The 3-year cumulative probability of diverticulitis and surgery was of 3.3% (95% CI 2.5% to 4.5%) in DICA 1, 11.6% (95% CI 9.2% to 14.5%) in DICA 2 and 22.0% (95% CI 17.2% to 28.0%) in DICA 3 (p<0.001), and 0.15% (95% CI 0.04% to 0.59%) in DICA 1, 3.0% (95% CI 1.9% to 4.7%) in DICA 2 and 11.0% (95% CI 7.5% to 16.0%) in DICA 3 (p<0.001), respectively. The 3-year cumulative probability of diverticulitis and surgery was ≤4%, and ≤0.7% in CODA A; <10% and <2.5% in CODA B; >10% and >2.5% in CODA C, respectively. The CODA score showed optimal discrimination capacity in predicting the risk of surgery in the development (c-statistic: 0.829; 95% CI 0.811 to 0.846) and validation cohort (c-statistic: 0.943; 95% CI 0.905 to 0.981). Conclusions DICA classification has a significant role in predicting the risk of diverticulitis and surgery in patients with diverticulosis, which is significantly enhanced by the CODA score. Trial registration number [NCT02758860][1]. Data are available upon reasonable request. [1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02758860&atom=%2Fgutjnl%2Fearly%2F2021%2F12%2F07%2Fgutjnl-2021-325574.atom

中文翻译：

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“DICA”内镜分类和“CODA”评分在预测憩室病临床结果中的预后表现：一项国际、多中心、前瞻性队列研究

目的探讨憩室炎症和并发症评估 (DICA) 分类的预测价值，并开发和验证用于预测憩室病临床结果的内镜-临床综合评分，称为憩室评估综合概述 (CODA)。设计 一项多中心、前瞻性、国际队列研究。在欧洲和南美洲设置了 43 个胃肠病学和内窥镜检查中心。首次诊断为憩室病/憩室病的 2215 名患者（2198 名完成研究）入组。根据 DICA 分类对患者进行评分。干预 进行了 3 年的随访。主要结局指标 根据 DICA 分类预测急性憩室炎和手术。审查观察的生存方法被用来开发和验证一种新的内窥镜-临床综合评分，用于预测憩室炎和手术（CODA 评分）。结果 DICA 1 中憩室炎和手术的 3 年累积概率为 3.3%（95% CI 2.5% 至 4.5%），DICA 2 中为 11.6%（95% CI 9.2% 至 14.5%）和 22.0%（95% DICA 3 的 CI 17.2% 至 28.0%）（p<0.001），DICA 1 的 0.15%（95% CI 0.04% 至 0.59%），DICA 2 和 11.0 的 3.0%（95% CI 1.9% 至 4.7%） DICA 3 (p<0.001) 中的 % (95% CI 7.5% 至 16.0%)。憩室炎和手术的3年累积概率≤4%，CODA A≤0.7%；在 CODA B 中 <10% 和 <2.5%；CODA C 中分别 >10% 和 >2.5%。CODA 评分在预测发育过程中的手术风险方面显示出最佳辨别能力（c 统计量：0.829；95% CI 0. 811 至 0.846）和验证队列（c 统计量：0.943；95% CI 0.905 至 0.981）。结论 DICA 分类在预测憩室病患者憩室炎和手术风险方面具有显着作用，CODA 评分显着提高了这一点。试用注册号 [NCT02758860][1]。可根据合理要求提供数据。[1]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT02758860&atom=%2Fgutjnl%2Fearly%2F2021%2F12%2F07%2Fgutjnl-2021-325574.atom