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Purpose <p>This study compared the diagnostic and prognostic performance of the Pan-Immune Inflammation Value (PIIV) and C-reactive protein (CRP) in assessing disease severity and predicting clinical outcomes in patients with acute left colonic diverticulitis (ALCD) classified according to the World Society for Emergency Surgery (WSES) guidelines.</p> Methods <p>A retrospective cohort study was conducted including 281 patients diagnosed with ALCD at a single center between January 2017 and June 2025. Patients were stratified according to WSES classification as uncomplicated (Stage 0), moderately severe (Stage 1a/1b), and severely complicated (Stage 2a–4). Demographic data, clinical characteristics, and laboratory parameters (CRP and PIIV) obtained at admission and at 48&#xa0;h were analyzed. Statistical analyses included ROC curve analysis, ANOVA, Kruskal–Wallis testing, and multivariable logistic regression. A p-value &lt; 0.05 was considered statistically significant.</p> Results <p>Among the patients, 146 (51.9%) had uncomplicated disease, 87 (30.9%) had moderately severe disease, and 48 (17.2%) had severe complicated disease. Neither biomarker reliably differentiated uncomplicated from moderately severe cases; however, PIIV showed superior discriminatory ability (AUC 0.72 vs. 0.54, <i>p</i> = 0.005). PIIV also outperformed CRP in identifying severe complicated disease (AUC 0.85 vs. 0.76, <i>p</i> = 0.021). The optimal cutoff values for severe disease were<i>1429.00</i> for PIIV (sensitivity 78.4%, specificity 81.1%) and 123.80&#xa0;mg/L for CRP (sensitivity 70.3%, specificity 73.1%). PIIV was an independent predictor of invasive interventions (<i>OR 1.04 per 100-unit increase</i>,<i> 95% CI 1.02–1.07</i>, <i>p</i> = 0.001).</p> Conclusion <p>PIIV is superior to CRP for evaluating disease severity and predicting adverse outcomes in ALCD and may improve early risk stratification and patient management.</p>

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Comparison of Pan-Immune Inflammation Value (PIIV) and C-Reactive Protein (CRP) as Severity Markers in Acute Left-Colonic Diverticulitis Based on WSES Classification: A Retrospective Cohort Study

  • 期刊论文

  • 发表日期：

    2026年6月30日

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  • Medeni Şermet,
  • Gülnihal Çelik,
  • Ozgur Ekinci,
  • Mehmet Sait Özsoy,
  • Nesrin Gündüz,
  • Orhan Alimoglu

摘要

Purpose

This study compared the diagnostic and prognostic performance of the Pan-Immune Inflammation Value (PIIV) and C-reactive protein (CRP) in assessing disease severity and predicting clinical outcomes in patients with acute left colonic diverticulitis (ALCD) classified according to the World Society for Emergency Surgery (WSES) guidelines.

Methods

A retrospective cohort study was conducted including 281 patients diagnosed with ALCD at a single center between January 2017 and June 2025. Patients were stratified according to WSES classification as uncomplicated (Stage 0), moderately severe (Stage 1a/1b), and severely complicated (Stage 2a–4). Demographic data, clinical characteristics, and laboratory parameters (CRP and PIIV) obtained at admission and at 48 h were analyzed. Statistical analyses included ROC curve analysis, ANOVA, Kruskal–Wallis testing, and multivariable logistic regression. A p-value < 0.05 was considered statistically significant.

Results

Among the patients, 146 (51.9%) had uncomplicated disease, 87 (30.9%) had moderately severe disease, and 48 (17.2%) had severe complicated disease. Neither biomarker reliably differentiated uncomplicated from moderately severe cases; however, PIIV showed superior discriminatory ability (AUC 0.72 vs. 0.54, p = 0.005). PIIV also outperformed CRP in identifying severe complicated disease (AUC 0.85 vs. 0.76, p = 0.021). The optimal cutoff values for severe disease were1429.00 for PIIV (sensitivity 78.4%, specificity 81.1%) and 123.80 mg/L for CRP (sensitivity 70.3%, specificity 73.1%). PIIV was an independent predictor of invasive interventions (OR 1.04 per 100-unit increase, 95% CI 1.02–1.07, p = 0.001).

Conclusion

PIIV is superior to CRP for evaluating disease severity and predicting adverse outcomes in ALCD and may improve early risk stratification and patient management.