Preoperative C-reactive protein predicts the severity and likelihood of complications following appendicectomy
| Autor: | J A Shelton, J J S Brown, J A Young |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
medicine.medical_specialty Adolescent Risk Assessment Preoperative care Young Adult Postoperative Complications Risk Factors Preoperative Care Appendectomy Humans Medicine In patient Young adult Child Laparoscopy Aged Aged 80 and over medicine.diagnostic_test biology business.industry C-reactive protein General Medicine Complicated appendicitis Middle Aged Appendicitis medicine.disease Surgery Lower GI Surgery C-Reactive Protein Child Preschool biology.protein business Risk assessment |
| Zdroj: | The Annals of The Royal College of Surgeons of England. 96:369-372 |
| ISSN: | 1478-7083 0035-8843 |
| Popis: | Introduction Diagnostic laparoscopy with appendicectomy (LA) has become the accepted method of investigation and treatment of appendicitis. However, concerns remain in cases of complicated appendicitis when many advocate conversion to an open procedure (LCOA) owing to the risk of complications. The aim of this study was to look for factors that could predict complications occurring in patients undergoing appendicectomy. Methods Data inclusive of all consecutive appendicectomies over a two-year period were retrieved from the computerised theatre database. Clinical details including admission inflammatory markers, complications, severity (final pathology) and length of stay were collected from the discharge letter. Readmissions were identified as those hospital identifiers had a second set of admission dates and/or a second discharge letter. Results During the 2-year study period, 517 appendicectomies were performed. Of these, 429 patients (83%) had LA and the remaining 88 (17%) had LCOA. The LA group had a mean age of 28 years (range: 2–86 years) and a mean C-reactive protein (CRP) level of 71mg/l (range: 0–480mg/l) while the LCOA group had a mean age of 46 years (range: 11–92 years) and a mean CRP level of 162mg/l (range: 3–404mg/l). These differences in age and CRP were significant (p150mg/l (pConclusions A high preoperative CRP level predicts an increased rate of postoperative complication due to established inflammation and/or infection. This raises the question of whether we should be offering primary open appendicectomies to patients with a CRP level of >150mg/l. |
| Databáze: | OpenAIRE |
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