Prognosis: Clinical Scenario
A seventy-five year old retired headmistress sees you in the clinic after a recent emergency admission with a peridiverticular abscess. This was successfully managed with five days of intravenous antibiotics, but your patient is knowledgeable and understands that the underlying bowel condition is unchanged. She asks what the risks of a second emergency admission are for someone in her position. She is clearly weighing up the possibility of undergoing elective surgery to prevent any recurrence. You tell her you will review the literature to find out the chances of repeated severe complications in patients who have had one emergency admission for a complication. You explain that the risks are of recurrent peridiverticulitis, abscess or phlegmon formation, perforation, obstruction or haemorrhage. You formulate the query: In patients admitted as an emergency with complications of diverticular disease, what is the risk of a second emergency admission for further complications?
You search Medline using the terms 'diverticulosis' and 'complications' and find a relevant article. Br J Surg 1994;81:733-5
Read the article and decide:
- Are the results of this study of prognosis valid?
- Are the results of the study important?
- Can you apply this valid, important evidence about prognosis to the treatment of your patient?