Discriminating Between Simple and Perforated Appendicitis

Autor: Tim Schepers, Mirelle E.E. Bröker, Maarten Van der Elst, Esther M.M. Van Lieshout, Laurents P. S. Stassen
Přispěvatelé: Surgery, RS: NUTRIM - R2 - Gut-liver homeostasis
Rok vydání: 2012
Předmět:
Male
Abdominal pain
CHILDREN
Body Temperature
Cohort Studies
Leukocyte Count
HISTORY
Child
Aged
80 and over
Univariate analysis
Perforation
biology
medicine.diagnostic_test
Incidence
Middle Aged
C-Reactive Protein
Child
Preschool
Erythrocyte sedimentation rate
Female
medicine.symptom
Adult
medicine.medical_specialty
Adolescent
Perforation (oil well)
White blood cell count
Blood Sedimentation
DIAGNOSIS
Diagnosis
Differential
Young Adult
Internal medicine
Erythrocyte Sedimentation Rate levels
MANAGEMENT
medicine
Appendectomy
Humans
Medical history
Aged
Retrospective Studies
business.industry
C-reactive protein
Retrospective cohort study
PREDICTIVE-VALUE
Appendicitis
medicine.disease
Abdominal Pain
Surgery
Logistic Models
C-REACTIVE-PROTEIN
RUPTURED APPENDICITIS
Multivariate Analysis
biology.protein
business
Zdroj: Journal of surgical research, 176(1), 79-83. Academic Press Inc.
Journal of Surgical Research, 176(1), 79-83. Academic Press
Journal of Surgical Research, 176(1), 79-83. Elsevier Science
ISSN: 0022-4804
DOI: 10.1016/j.jss.2011.09.049
Popis: Background. Several studies have been performed in order to diagnose an acute appendicitis using history taking and laboratory investigations. The aim of this study was to create a model for the identification of a perforated appendicitis. Methods. All consecutive patients who have undergone an appendectomy in the Reinier de Graaf hospital between January 1, 2007 and July 31, 2009, were included in a retrospective cohort study. Baseline patient characteristics, history and laboratory data were collected. Variables discriminating perforated from non-perforated appendicitis were identified using univariate and multivariable analyses. Results. A total of 498 patients were included in the study. In the univariate analysis leukocyte count, C-Reactive Protein levels, Erythrocyte Sedimentation Rate levels, days of symptoms and temperature were identified as predictors of perforated appendicitis. The predicted probability (P) of a perforated appendicitis can be calculated from the following model: (P) = 1/(1 + e(-(-2.788 + 0.012 * CRP + 0.207 * days with complaints))). Conclusions. Perforation of appendicitis can be predicted from the CRP level and the duration of abdominal pain. These findings might influence the choice between conservative or surgical treatment of appendicitis, and could provide guidance in the early start of antibiotics. (C) 2012 Elsevier Inc. All rights reserved.
Databáze: OpenAIRE
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