Predictors of in-hospital appendiceal perforation in patients with non- perforated acute appendicitis with appendicolithiasis at presentation
Abstract Introduction Appendicolithiasis is a risk factor for perforated acute appendicitis. There is limited inpatient data on predictors of progression in appendicolithiasis-associated non-perforated acute appendicitis. Methods We identified adults presenting with appendicolithiasis-associated non...
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| Format: | Article |
| Language: | English |
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BMC
2023-10-01
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| Series: | BMC Surgery |
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| Online Access: | https://doi.org/10.1186/s12893-023-02210-4 |
| _version_ | 1797578442306224128 |
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| author | Amir H. Sohail Hazim Hakmi Koral Cohen Joshua C. Hurwitz Jasmine Brite Sawyer Cimaroli Harry Tsou Michael Khalife James Maurer Matthew Symer |
| author_facet | Amir H. Sohail Hazim Hakmi Koral Cohen Joshua C. Hurwitz Jasmine Brite Sawyer Cimaroli Harry Tsou Michael Khalife James Maurer Matthew Symer |
| author_sort | Amir H. Sohail |
| collection | DOAJ |
| description | Abstract Introduction Appendicolithiasis is a risk factor for perforated acute appendicitis. There is limited inpatient data on predictors of progression in appendicolithiasis-associated non-perforated acute appendicitis. Methods We identified adults presenting with appendicolithiasis-associated non-perforated acute appendicitis (on computed tomography) who underwent appendectomy. Logistic regression was used to investigate predictors of in-hospital perforation (on histopathology). Results 296 patients with appendicolithiasis-associated non-perforated acute appendicitis were identified; 48 (16.2%) had perforation on histopathology. Mean (standard deviation [SD]) age was 39 (14.9) years. The mean (SD) length of stay (LOS) was 1.5 (1.8) days. LOS was significantly longer with perforated (mean [SD]: 3.0 [3.1] days) vs. non-perforated (mean [SD]: 1.2 [1.2] days) appendicitis (p < 0.001). On multivariate analysis, in-hospital perforation was associated with age > 65 years (OR 5.4, 95% CI: 1.4- 22.2; p = 0.015), BMI > 30 kg/m2 (OR 3.5, 95% CI: 1.3–8.9; p = 0.011), hyponatremia (OR 3.6, 95% CI: 1.3–9.8; p = 0.012). There was no significant association with age 25–65 years, gender, race, steroids, time-to- surgery, neutrophil percentage, or leukocyte count. Conclusion Geriatric age, obesity, and hyponatremia are associated with progression to perforation in appendicolithiasis-associated non-perforated acute appendicitis. |
| first_indexed | 2024-03-10T22:21:57Z |
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| id | doaj.art-26c8303b2caf4ee5bbbf5bc1898a3a54 |
| institution | Directory Open Access Journal |
| issn | 1471-2482 |
| language | English |
| last_indexed | 2024-03-10T22:21:57Z |
| publishDate | 2023-10-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Surgery |
| spelling | doaj.art-26c8303b2caf4ee5bbbf5bc1898a3a542023-11-19T12:13:32ZengBMCBMC Surgery1471-24822023-10-012311510.1186/s12893-023-02210-4Predictors of in-hospital appendiceal perforation in patients with non- perforated acute appendicitis with appendicolithiasis at presentationAmir H. Sohail0Hazim Hakmi1Koral Cohen2Joshua C. Hurwitz3Jasmine Brite4Sawyer Cimaroli5Harry Tsou6Michael Khalife7James Maurer8Matthew Symer9Department of Surgery, NYU Langone Long IslandDepartment of Surgery, NYU Langone Long IslandNYU Long Island School of MedicineNYU Long Island School of MedicineNYU Long Island School of MedicineDepartment of Surgery, NYU Langone Long IslandDepartment of Surgery, NYU Langone Long IslandDepartment of Surgery, NYU Langone Long IslandMount Sinai South Nassau Hospital Department of SurgeryDepartment of Surgery, NYU Langone Long IslandAbstract Introduction Appendicolithiasis is a risk factor for perforated acute appendicitis. There is limited inpatient data on predictors of progression in appendicolithiasis-associated non-perforated acute appendicitis. Methods We identified adults presenting with appendicolithiasis-associated non-perforated acute appendicitis (on computed tomography) who underwent appendectomy. Logistic regression was used to investigate predictors of in-hospital perforation (on histopathology). Results 296 patients with appendicolithiasis-associated non-perforated acute appendicitis were identified; 48 (16.2%) had perforation on histopathology. Mean (standard deviation [SD]) age was 39 (14.9) years. The mean (SD) length of stay (LOS) was 1.5 (1.8) days. LOS was significantly longer with perforated (mean [SD]: 3.0 [3.1] days) vs. non-perforated (mean [SD]: 1.2 [1.2] days) appendicitis (p < 0.001). On multivariate analysis, in-hospital perforation was associated with age > 65 years (OR 5.4, 95% CI: 1.4- 22.2; p = 0.015), BMI > 30 kg/m2 (OR 3.5, 95% CI: 1.3–8.9; p = 0.011), hyponatremia (OR 3.6, 95% CI: 1.3–9.8; p = 0.012). There was no significant association with age 25–65 years, gender, race, steroids, time-to- surgery, neutrophil percentage, or leukocyte count. Conclusion Geriatric age, obesity, and hyponatremia are associated with progression to perforation in appendicolithiasis-associated non-perforated acute appendicitis.https://doi.org/10.1186/s12893-023-02210-4Acute AppendicitisPerforated AppedicitisAppendectomyRisk FactorsAppendicolith |
| spellingShingle | Amir H. Sohail Hazim Hakmi Koral Cohen Joshua C. Hurwitz Jasmine Brite Sawyer Cimaroli Harry Tsou Michael Khalife James Maurer Matthew Symer Predictors of in-hospital appendiceal perforation in patients with non- perforated acute appendicitis with appendicolithiasis at presentation BMC Surgery Acute Appendicitis Perforated Appedicitis Appendectomy Risk Factors Appendicolith |
| title | Predictors of in-hospital appendiceal perforation in patients with non- perforated acute appendicitis with appendicolithiasis at presentation |
| title_full | Predictors of in-hospital appendiceal perforation in patients with non- perforated acute appendicitis with appendicolithiasis at presentation |
| title_fullStr | Predictors of in-hospital appendiceal perforation in patients with non- perforated acute appendicitis with appendicolithiasis at presentation |
| title_full_unstemmed | Predictors of in-hospital appendiceal perforation in patients with non- perforated acute appendicitis with appendicolithiasis at presentation |
| title_short | Predictors of in-hospital appendiceal perforation in patients with non- perforated acute appendicitis with appendicolithiasis at presentation |
| title_sort | predictors of in hospital appendiceal perforation in patients with non perforated acute appendicitis with appendicolithiasis at presentation |
| topic | Acute Appendicitis Perforated Appedicitis Appendectomy Risk Factors Appendicolith |
| url | https://doi.org/10.1186/s12893-023-02210-4 |
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