Development and validation of risk prediction score for incisional surgical site infection after appendectomy

Emile, Sameh Hany; Elfallal, Ahmed Hossam; Elbaz, Samy Abbas; Elmetwally, Ahmed

doi:10.1007/s13304-020-00944-x

Cited by 7 publications

(4 citation statements)

References 29 publications

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“…The impact of chronic health conditions on the development of surgical site infection (SSI), particularly following appendectomy, remains poorly understood. Previous studies focusing on clean surgeries like spinal procedures [17] identified obesity as an independent risk factor for both deep and superficial SSI; additionally, a study on 343 patients with SSI found diabetes mellitus and obesity as independent predictors of SSI [18]. Similar findings were reported in a meta-analysis of multiple surgical procedure types [19].…”

Section: Discussionsupporting

confidence: 70%

Acute Appendicitis in the Elderly: A Nationwide Retrospective Analysis

Gal,

Maya,

Ofer

et al. 2024

JCM

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Background: Acute appendicitis (AA) in older individuals remains understudied. We aimed to assess AA characteristics in patients older than 60 years and evaluate the impact of comorbidities. Methods: This retrospective study analyzed data from the American National Inpatient Sample between 2016 and 2019 to compare AA characteristics in patients younger and older than 60 years. Results: Of the 538,400 patients included, 27.5% were older than 60 years. Younger patients had a higher appendectomy rate (p < 0.01), while the complicated appendicitis rate was higher in older patients. Superficial wound infection, systemic infection, and mortality rates were higher in older patients (p < 0.01). Risk factors for superficial wound infection in patients younger than 60 years included cerebrovascular disease, chronic kidney disease, hypertension, heart failure, and obesity, whereas only heart failure was a risk factor in older patients. Risk factors for systemic infection in young patients included hypertension, heart failure, obesity, and diabetes mellitus, while in older patients they included hypertension, heart failure, and obesity. Complicated appendicitis was not a risk factor for infections in either group. Conclusions: This study highlights a higher incidence of AA in older individuals than previously reported, with comorbidities posing differing risks for infections between age groups.

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Section: Discussionsupporting

confidence: 70%

Acute Appendicitis in the Elderly: A Nationwide Retrospective Analysis

Gal,

Maya,

Ofer

et al. 2024

JCM

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“…There was wide disagreement about how time to surgery influences surgical outcomes (Abdul Jawad et al 2021 ; Almstrom et al 2017 ; Boomer et al 2016 ; Boomer et al 2014 ; Ditillo et al 2006 ; Drake et al 2014 ; Giraudo et al 2013 ; Kearney et al 2008 ; Meltzer et al 2019 ; Teixeira et al 2012 ; van Dijk et al 2018 ), but few studies have attempted to identify specific patients potentially affected by the surgical delay. Several scoring or grading systems for predicting surgical outcomes were proposed, but most required intraoperative findings (Emile et al 2021 ; Finnesgard et al 2018 ; Noorit et al 2018 ; Vasileiou et al 2019 ), which means those systems could not help reverse these complications. Our study used a multivariate logistic regression model consisting of preoperative factors to classify patients into high and low risk.…”

Section: Discussionmentioning

confidence: 99%

Impact of preoperative factors and waiting time on post-appendectomy complications: a retrospective study

Lai,

Chang,

Lee

et al. 2024

Perioper Med

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Background Several factors are associated with increased postoperative complications after appendectomies. However, few studies combined these potential factors for comprehensive prediction of surgical outcomes. Whether high-risk patients benefit from a shorter waiting time for surgery remains unclear. This study aimed to explore the impact of surgical waiting time and potential risk factors on postoperative complications. Methods A total of 1343 patients diagnosed with acute appendicitis requiring an emergent appendectomy were included from 2013 to 2018. The preoperative risk factors associated with postoperative complications were selected and the probability of postoperative complications was calculated by multivariate logistic regression model. Patients were divided into four groups based on the risk (high & low) and time to surgery (> 12 & ≤12 hours). The odds ratios for complications were evaluated between groups. Results The selected risk factors included age, neutrophil-lymphocyte ratio, systemic inflammatory response syndrome and abdominal pain duration. Compared with low-risk patients with time to surgery ≤12 hours, high-risk patients with time to surgery > 12 hours had significant increased overall postoperative complication rate (16.85% vs. 8.16%, p = 0.002) and a trend toward increased surgical site infection rate (10.99% vs. 6.46%, p = 0.058). When operated within 12 hours, there was no difference in outcomes between high- and low-risk patients. On the other hand, time to surgery > 12 hours did not increase complication rate in low-risk patients. Conclusions The surgical outcome may be affected by preoperative factors and time to surgery. It is suggested that high-risk patients receive appendectomy within 12 hours to avoid increased postoperative complications.

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“…The number of patients who underwent open surgery increased in the post-pandemic era, and the rate of postoperative complications was also significantly higher than before, particularly the rate of surgical site infections. Of course, The increase in gangrenous perforative appendicitis (Table 3 ) also contributed to these negative outcomes [ 27 ]. Therefore, we could not conclude that the significant decrease in the number of laparoscopic appendectomies results in an increased incidence of complications, but it is at least a risk factor.…”

Section: Discussionmentioning

confidence: 99%

Decision-making changes for patients and medical personnel in the management of acute appendicitis during the COVID-19 pandemic

Cai

Zheng

et al. 2022

BMC Emerg Med

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Background Acute appendicitis is the most common cause of acute abdomen. During the pandemic, to contain the spread of COVID-19, there were some integral changes in the medical processes based on the pandemic prevention policy, especially regarding emergency surgery. This study was conducted to investigate whether this pandemic also impacted the decision-making for both patients and medical personnel along with the treatment outcomes. Methods Patients of age 18 years or older who were diagnosed clinically and radiologically with acute appendicitis between Jan 1, 2017, and Dec 31, 202,0 were reviewed. The data of 1991 cases were collected and used for this study. Two groups were formed, one group before and the other group after the outbreak. The gathered data included gender, age, appendiceal fecalith, outcomes of treatment, and long-term outcomes of non-operation (8 months follow-up). We also collected details of surgical cases from the above two groups. This data also included age, gender, appendiceal fecalith, fever, jaundice, length of onset before presenting to an emergency department (ED), anesthesia, surgery, white cell count, pathology, complications, and length of stay. We compared the above data respectively and analyzed the differences. Results Compared to the period before the outbreak, patient visits for acute appendicitis remarkably dropped (19.8%), but surgical cases showed no change (dropped by roughly 5%). There were significant differences (P < 0.05) in failure of non-operation(after the pandemic 8.31% vs. before pandemic 3.22%), interval appendectomy(after pandemic 6.29% vs. before pandemic 12.84%), recurrence(after pandemic 23.27% vs. before pandemic 14.46%), and outcomes of recurrence. There was a significant difference (P < 0.05) in anesthesia method, surgery way, and complications( before pandemic 4.15% vs. after pandemic9.89% P < 0.05) in patients who underwent the surgery. There was no statistical difference (P > 0.05) concerning age, gender, fever, jaundice, appendiceal fecalith, white cell count, and length of onset before presenting to the ED. Conclusion The current pandemic prevention policy is very effective, but some decision-making processes of doctor-patient have changed in the context of COVID-19 pandemic, that further influenced some treatment outcomes and might lead to a potential economic burden. It is essential to address the undue concern of everyone and optimize the treatment process.

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Development and validation of risk prediction score for incisional surgical site infection after appendectomy

Cited by 7 publications

References 29 publications

Acute Appendicitis in the Elderly: A Nationwide Retrospective Analysis

Acute Appendicitis in the Elderly: A Nationwide Retrospective Analysis

Impact of preoperative factors and waiting time on post-appendectomy complications: a retrospective study

Decision-making changes for patients and medical personnel in the management of acute appendicitis during the COVID-19 pandemic

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