Risk Factors for Complications in Acute Appendicitis among Paediatric Population

Poudel, Rajesh; Bhandari, Tika Ram

doi:10.31729/jnma.2930

Cited by 12 publications

(9 citation statements)

References 16 publications

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“…At present, the preoperative assessment of using stress response indicators for CA were more confined to children with acute appendicitis, [12,30] but has been less reported in adults. The subject regards postoperative pathology as the standard.…”

Section: Discussionmentioning

confidence: 99%

“…[10] This was because the periappendiceal abscess often needs to be conservatively treated, such as the introduction of antibiotics or catheter drainage, [11] which is different from the treatment for acute gangrenous or perforated appendicitis. [12] In the present study, patients with periappendiceal abscess were excluded and not discussed for CA. This was because the CA in the present study refers to acute gangrenous appendicitis or perforated appendicitis.…”

Section: Introductionmentioning

confidence: 99%

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Preoperative assessment of complicated appendicitis through stress reaction and clinical manifestations

Kang¹,

Li²,

Zheng³

et al. 2019

Medicine

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This study assessed the severity of the disease through the preoperative clinical manifestations and inflammatory reaction indicators of acute appendicitis, and established a score table to predict complicated appendicitis (CA). The clinical data of 238 patients with acute appendicitis in our hospital were retrospectively analyzed, which included 18 patients with acute simple appendicitis (7.6%), 170 patients with acute purulent appendicitis (72.0%), and 48 patients with acute gangrene and perforation (20.3%). The clinical manifestations and inflammatory reaction indicators were analyzed by univariate logistic regression. Multivariate logistic regression analysis was performed to screen out the independent risk factors of CA. The β coefficients of independent risk factors entering the multivariate model were assigned by rounding, and the total score was the sum of values of all factors. Finally, verification and analysis were performed for the predictive model, and the operating characteristic curve (ROC) curve was drawn. Then, the area under the curve (AUC) was compared with the THRIVE scale, and the Hosmer–Lemeshow method was used to evaluate whether the model fitted well. The multivariate logistic regression analysis of independent risk factors was performed, and the values were rounded to the variable assignment based on the β coefficient values. The plotted ROC and AUC was calculated as 0.857 ( P < .001). Using the Hosmer–Lemeshow method, the X 2 -value was 12.430, suggesting that the prediction model fitted well. The scoring system can quickly determine whether this is a CA, allowing for an earlier and correct diagnosis and treatment. Furthermore, the scoring system was convenient, economical, and affordable. Moreover, it is easy to popularized and promote.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Preoperative assessment of complicated appendicitis through stress reaction and clinical manifestations

Kang¹,

Li²,

Zheng³

et al. 2019

Medicine

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“…The complete blood count (CBC) is one of the most commonly used laboratory tests for the diagnosis of AA. Many studies have focused on the role of white blood cell (WBC), neutrophil-to-lymphocyte ratio (NLR), platelet distribution width (PDW), mean platelet volume (MPV), red cell distribution width (RDW), platelet count (PLT), lymphocyte (L), neutrophil (N), C-reactive protein (CRP), and Lymphocyte-C-reactive protein ratio (LCR) values in the diagnosis of AA [4,8,[16][17][18]. We aimed to investigate the diagnostic efficacy of CBC parameters, CRP, and LCR in AA diagnosis and their relationship with appendix diameter.…”

Section: Introductionmentioning

confidence: 99%

The Correlation between Complete Blood Count Parameters and Appendix Diameter for the Diagnosis of Acute Appendicitis

Daldal

Dagmura

2020

Healthcare

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Acute appendicitis is one of the most common causes of acute abdominal diseases seen between the ages of 10 and 19, mostly seen in males. The lifetime risk of developing acute appendicitis is 8.6% for males and 6.7% for females. We aimed to investigate the efficacy of the complete blood count parameters, C-reactive protein, and Lymphocyte-C-reactive Protein Ratio laboratory tests in the diagnosis of acute appendicitis, as well as their relationship with appendix diameter. We retrospectively examined all patients who underwent appendectomy between 1 January 2012 and 30 June 2019 in the General Surgery Clinic of Gaziosmanpasa University Faculty of Medicine. Laboratory tests, imaging findings, age, and gender were recorded. Lymphoid hyperplasia is considered as normal appendix—in other words, as negative appendicitis. The distribution of Lymphoid hyperplasia and appendicitis rates were statistically different in the groups formed according to appendix diameter (≤6 and >6 mm) (p < 0.001). We found a significant correlation between appendix diameter and WBC (White blood count), Lymphocyte, Neutrophil, RDW(Red blood cell distribution width), NLR(Neutrophil to lymphocyte ratio), and PLT/L (Platelet to lymphocyte ratio), MPV (Mean platelet volume) and RDW were significantly different in patients with an appendix diameter of ≤6 mm (p = 0.007, p = 0.006, respectively). WBC, Neutrophil, PDW, and NLR values were significantly different between appendicitis and hyperplasia groups in patients with an appendix diameter of >6 mm. The sensitivity of the NLR score (cutoff = 2.6057) in the diagnosis of appendicitis was 86.1% and selectivity was 50% in these patients. Complete blood count parameters evaluation with the clinical findings revealed that NLR is an important parameter that may help the diagnosis of acute appendicitis with an appendix diameter of >6 mm. In patients whose pathological results indicated acute appendicitis but who had a diameter of ≤6 mm, we found an elevated MPV and low RDW values.

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“…APR stands at 10%, 44% and > 40% if appendicitis is diagnosed at 18 h, 36 h and > 48 h, respectively, from symptom onset. In comparison, Poudel and Bhandari ( 8 ) reported that patients with abdominal pain of > 72 h are more likely to have complicated appendicitis. Williams and Kapila ( 25 ) reported that fever is present in up to 90% of cases of appendicitis, and Siddique et al ( 9 ) reported that body temperature on admission is higher for patients with PA. Our study showed similar results.…”

Section: Discussionmentioning

confidence: 98%

A Study on the Clinical Factors Associated with Acute Appendicitis and Perforated Appendicitis among Children in a Secondary Medical Centre in Malaysia

Tan

Teng

Gan

et al. 2020

MJMS

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Background Appendicitis complicated with appendiceal perforation is common among children. The delay in diagnosis of appendicitis is due to children’s varied presentations and their difficulty in communicating symptoms. We aimed to identify clinical factors that aid in predicting acute appendicitis (AA) and perforated appendicitis (PA) among children. Methods This retrospective study involved 215 children aged 12 years and below with the initial diagnosis of AA and PA. Clinical factors studied were demographics, presenting symptoms, body temperature on admission (BTOA), white cell count (WCC), absolute neutrophil count (ANC), platelet count and urinalysis. Simple and multiple logistic regressions were used to determine the odds ratio of the statistically significant clinical factors. Results: The mean age of the included children was 7.98 ± 2.37 years. The odds of AA increased by 2.177 times when the age was ≥ 8 years ( P = 0.022), 2.380 times when duration of symptoms ≥ 2 days ( P = 0.011), 2.447 times with right iliac fossa (RIF) pain ( P = 0.007), 2.268 times when BTOA ≥ 38 °C ( P = 0.020) and 2.382 times when neutrophil percentage was ≥ 76% ( P = 0.045). It decreased by 0.409 times with non-RIF pain ( P = 0.007). The odds of PA was increased by 4.672 times when duration of symptoms ≥ 2 days ( P = 0.005), 3.611 times when BTOA ≥ 38 °C ( P = 0.015) and 3.678 times when neutrophil percentage ≥ 76% ( P = 0.016). There was no significant correlation between WCC and ANC with AA and PA. Conclusion Older children with longer duration of symptoms, RIF pain and higher BTOA are more likely to have appendicitis. The risk of appendiceal perforation increases with longer duration of symptoms and higher BTOA.

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Risk Factors for Complications in Acute Appendicitis among Paediatric Population

Cited by 12 publications

References 16 publications

Preoperative assessment of complicated appendicitis through stress reaction and clinical manifestations

Preoperative assessment of complicated appendicitis through stress reaction and clinical manifestations

The Correlation between Complete Blood Count Parameters and Appendix Diameter for the Diagnosis of Acute Appendicitis

A Study on the Clinical Factors Associated with Acute Appendicitis and Perforated Appendicitis among Children in a Secondary Medical Centre in Malaysia

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