Risk factors for the development of complicated appendicitis in adults
Mohammad Naderan, Amir Eslami Shahr Babaki, Saeed Shoar, Hossein Mahmoodzadeh, Shirzad Nasiri, Zhamak Khorgami
Department of Surgery, Tehran University of Medical Sciencest, Shariati Hospital, Tehran , Iran
Objective: To investigate the patient’s history and physical examination information to find out risk factors associated with complicated appendicitis.
Material and Methods: Two hundred patients who were admitted with complicated appendicitis (including abscess, phlegmon, and generalized peritonitis) were retrieved from our database. Two hundred patients with non-complicated acute appendicitis were randomly selected from the same period. These two groups were compared in terms of demographic characteristics, past medical history, and presenting symptoms. We made a multivariate analysis model using binary logistic regression and backward stepwise elimination.
Results: Based on multivariate analysis, risk factors for complicated appendicitis included presenting with epigastric pain (OR=3.44), diarrhea (OR=23.4) or malaise (OR=49.7), history of RLQ pain within the past 6 months (OR=4.93), older age (OR=1.04), being married (OR=2.52), lack of anorexia (OR=4.63) and longer interval between onset of symptoms and admission (OR=1.46). Conversely, higher (academic) education was associated with decreased odds for complicated appendicitis (OR=0.26).
Conclusion: Our findings suggest that a surgeon’s clinical assessment is more reliable to make a judgment. “Bedside evaluation” is a useful, cheap, quick and readily available method for identifying those at risk for developing complicated acute appendicitis.
Keywords: Acute appendicitis, complicated appendicitis, risk factors, adults
The ethics committee of the Shariati Hospital, Tehran University of Medical Science approved the study.
Concept - Z.K.; Design - Z.K., M.N.; Supervision - Z.K., M.N., S.N., H.M.; Resources - Z.K., M.N.; Materials - S.N., H.M.; Data Collection and/or Processing - M.N., S.S.; Analysis and/or Interpretation - Z.K., M.N., A.E.S.B., S.S.; Literature Search - Z.K., A.E.S.B., S.S.; Writing Manuscript - Z.K., M.N., A.E.S.B., S.S.; Critical Review - Z.K., M.N., S.N., H.M.; Other - S.N., H.M.
No conflict of interest was declared by the authors.
The authors declared that this study has received no financial support.