Risk factors for morbidity after appendectomy

Andert, Anne; Alizai, H. P.; Klink, Christian D.; Neitzke, N.; Fitzner, Christina; Heidenhain, Christoph; Kroh, Andreas; Neumann, Ulf; Binnebösel, Marcel

doi:10.1007/s00423-017-1608-3

Cited by 37 publications

(50 citation statements)

References 24 publications

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“…While our complication rates in the non-pandemic period were similar to the studies in the literature, the rate of complications was higher during the pandemic period [8,9]. The high level of postoperative wound infection and pneumonia during this period is noteworthy.…”

Section: Discussionsupporting

confidence: 87%

Characteristics and Outcomes of Acute Appendicitis Cases During the COVID-19 Pandemic

Başer

Katar

2020

Preprint

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Background: Our aim in this study was to investigate the effects of the COVID-19 pandemic on acute appendicitis cases.Methods: This study was designed as a single-center, retrospective, and observational study. The patients were divided into three groups relative to the date of the first COVID-19 case in Turkey, which was March 10, 2020 (Group A: before the pandemic; Group B: pandemic period; Group C: the same period one year before the pandemic). A total of 413 patients were included in the study.Results: In terms of treatment modality, the rate of open appendectomy was significantly higher in group B (p<0.001). Rates of conversion to open surgery, as well as rates of complicated appendicitis were also significantly higher in group B (p=0.027, p=0.024, respectively). While there was no difference between the groups in terms of preoperative hospitalization duration (p=0.102), it was found that the duration of symptoms, operation time, and postoperative length of hospital stay were significantly higher in Group B (p<0.001, p=0.011, p=0.001, respectively). In addition, the complication rate in group B (8.9%) was also significantly higher than in the other two groups (p=0.023).Conclusion: We found that the rate of open surgery, the rate of conversion of laparoscopic surgery to open surgery, complication rates, mean operation time, and postoperative hospital stay were significantly higher in acute appendicitis patients that underwent surgery during the COVID-19 pandemic period. We believe that the main reason for this negative outcome is the late admission of the patients to the hospital.

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Section: Discussionsupporting

confidence: 87%

Characteristics and Outcomes of Acute Appendicitis Cases During the COVID-19 Pandemic

Başer

Katar

2020

Preprint

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“…Perhaps the emphasis should not rely (solely) on intraoperative findings, but on more quantifiable variables, such as serum C‐reactive protein and white blood cell count. Several radiological and laboratory factors have been associated with adverse outcomes after appendicectomy. A combination of these and intraoperative findings may result in more consistent postoperative management.…”

Section: Discussionmentioning

confidence: 99%

Interobserver variability in the classification of appendicitis during laparoscopy

Boom

Wijkerslooth

Mauff

et al. 2018

British Journal of Surgery

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BackgroundThe intraoperative classification of appendicitis dictates the patient's postoperative management. Prolonged antibiotic prophylaxis is recommended for complex appendicitis (gangrenous, perforated, abscess), whereas preoperative prophylaxis suffices for simple appendicitis. Distinguishing these two conditions can be challenging. The aim of this study was to assess interobserver variability in the classification of appendicitis during laparoscopy.MethodsShort video recordings taken during laparoscopy for suspected appendicitis were shown to surgeons and surgical residents. They were asked to: classify the appendix as indicative of no, simple or complex appendicitis; categorize the appendix as normal, phlegmonous, gangrenous, perforated and/or abscess; and decide whether they would prescribe postoperative antibiotics. Inter‐rater reliability was evaluated using Fleiss' κ score and the S* statistic.ResultsSome 80 assessors participated in the study. Video recordings of 20 patients were used. Interobserver agreement was minimal for both the classification of appendicitis (κ score 0·398, 95 per cent c.i. 0·385 to 0·410) and the decision to prescribe postoperative antibiotic treatment (κ score 0·378, 0·362 to 0·393). Agreement was slightly higher when published criteria were applied (κ score 0·552, 0·537 to 0·568).ConclusionThere is considerable variability in the intraoperative classification of appendicitis and the decision to prescribe postoperative antibiotic treatment.

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“…In the study of Lasek et al, it was stated that conversion to open surgery had no effect on postoperative morbidity (17) . In the study of Andert et al, postoperative morbidity was observed more frequently in conversion from laparoscopy and it was found to be a risk factor for the development of morbidity in multivariate analysis (27) . In this study, conversion was found to be a effective factor for morbidity, and in the multivariate analysis, and an effective risk factor in the development of postoperative morbidity.…”

Section: Discussionmentioning

confidence: 96%

Risk Factors Affecting Postoperative Morbidity in Laparoscopic Treatment of Perforated Appendicitis, a Single Center Experience

Sürek¹,

Karabulut²

2020

BMJ

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Objective: Postoperative morbidity may occur more in laparoscopic treatment of perforated appendicitis than simple appendicitis. In this study, we aimed to investigate the risk factors affecting the development of morbidity in laparoscopic treatment of perforated appendicitis. Method: The files of patients who underwent laparoscopic appendectomy due to perforated appendicitis were analysed retrospectively. Finding of perforation has been documented by surgeons who performed surgery. Information on the patients such as age, gender, Charlson Comorbidity Index (CCI), body mass index (BMI), ASA scores, symptom onset time, time between hospital admission and surgery, surgical findings, perforation sites, type of surgery, stump closure materials, white blood cell counts, pathology results and postoperative morbidities were recorded. Data were compared between patients with and without morbidity, and multivariate regression analysis of variables with significant p value was performed. Results: The rate of morbidity development in laparoscopic treatment of perforated appendicitis was 22.14% (66/298). In multivariate regression analysis, the onset of symptoms longer than 72 hours, proximal perforation, grade 5 diffuse peritonitis in surgical finding according to Disease Severity Score (DSS), conversion from laparoscopic to open surgery and gangrene or necrosis in histopathological finding were found to be effective risk factors in the development of morbidity.

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Risk factors for morbidity after appendectomy

Cited by 37 publications

References 24 publications

Characteristics and Outcomes of Acute Appendicitis Cases During the COVID-19 Pandemic

Characteristics and Outcomes of Acute Appendicitis Cases During the COVID-19 Pandemic

Interobserver variability in the classification of appendicitis during laparoscopy

Risk Factors Affecting Postoperative Morbidity in Laparoscopic Treatment of Perforated Appendicitis, a Single Center Experience

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