American journal of surgery · 2017
Preoperative predictor of extensive resection for acute appendicitis.
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Saida Fumitaka, Matsumoto Shokei, Kitano Mitsuhide
Аннотация
BACKGROUND: Appendectomy has been the preferred treatment of acute appendicitis. However, extensive resection (ER) such as an ileocecal resection is sometimes needed. We analyzed the predictive factors of ER.
METHODS: This was a retrospective study of 927 patients with acute appendicitis in 7 years. The data collected, including demographic characteristics, laboratory tests, computed tomography (CT) findings and days from onset.
RESULTS: ER was performed in 40 patients (4.3%). Age, days from onset, C-reactive protein (CRP), and the presence of several CT findings were significantly higher in the ER group than others (p < 0.01). In a multivariate analysis, four variables (appendiceal mass, non-visualization of appendix, delayed admission, and CRP) retained statistical significance as predictors of ER (p < 0.01).
CONCLUSIONS: We demonstrated that the four factors are clinically useful for predicting preoperatively whether or not ER is required. These may help in management decisions, including surgical procedure and anesthesia.
METHODS: This was a retrospective study of 927 patients with acute appendicitis in 7 years. The data collected, including demographic characteristics, laboratory tests, computed tomography (CT) findings and days from onset.
RESULTS: ER was performed in 40 patients (4.3%). Age, days from onset, C-reactive protein (CRP), and the presence of several CT findings were significantly higher in the ER group than others (p < 0.01). In a multivariate analysis, four variables (appendiceal mass, non-visualization of appendix, delayed admission, and CRP) retained statistical significance as predictors of ER (p < 0.01).
CONCLUSIONS: We demonstrated that the four factors are clinically useful for predicting preoperatively whether or not ER is required. These may help in management decisions, including surgical procedure and anesthesia.