Unexpected complicated appendicitis in the elderly diagnosed with acute appendicitis

Dhillon, Navpreet K.; Barmparas, Galinos; Lin, Tsan‐Shiun; Alban, Rodrigo F.; Melo, Natália; Yang, Audrey R.; Margulies, Daniel R.; Ley, Eric J.

doi:10.1016/j.amjsurg.2019.08.013

Cited by 18 publications

(29 citation statements)

References 17 publications

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“… 9 , 10 On the other hand, non-operative management might not be suitable for elderly patients because of the high rate of complicated appendicitis. 11 In any event, delays in receiving treatment may be hazardous.…”

Section: Discussionmentioning

confidence: 99%

“…Several risk factors probably contribute to the development of complicated appendicitis. Dhillon et al found a close relationship between age and the prevalence of complicated appendicitis 11 (reviewer #2, comment #1). Naderan et al reported that complicated appendicitis occurred more in married patients, elder patients, and patients with lower levels of education or with a longer interval from the onset of symptoms to admission.…”

Section: Discussionmentioning

confidence: 99%

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Complicated appendicitis are common during the epidemic period of 2019 novel coronavirus (2019-nCoV)

Gao¹,

Li²,

Zhou³

et al. 2020

Asian Journal of Surgery

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Objectives To assess the prevalence of complicated appendicitis (including gangrene, abscess and perforation) after the outbreak of the 2019-nCoV epidemic and to identify the risk factors associated with complicated appendicitis. Methods Two groups were established in the study consisting of: one group for cases of acute appendicitis before the 2019-nCoV epidemic (before January 1, 2020; pre-epidemic group) and another group for those after the epidemic outbreak (after January 1, 2020; epidemic group). These two groups were compared in terms of demographic and clinical characteristics, prevalence of complicated appendicitis, and treatment intention. A multivariate analysis model using binary logistic regression was constructed. Results A total of 163 patients were included in this study, with 105 in the pre-epidemic group and 58 in the epidemic group. In the epidemic group, the interval from the onset of symptoms to admission was 65.0 h, which is significantly longer than the 17.3 h interval noted in the pre-epidemic group ( P < 0.001). The prevalence of complicated appendicitis after the epidemic outbreak was significantly higher than before the outbreak (51.7% vs. 12.4%, P < 0.001). In addition, the epidemic group had a lower score of patient’s intention to seek treatment than the pre-epidemic group (9.5 ± 2.7 vs. 3.4 ± 2.6, P < 0.001). Based on the multivariate analysis, the risk factors for complicated appendicitis included the time from symptoms onset to admission (OR = 1.075) and the patients’ intention to receive treatment (OR = 0.541). Conclusion Complicated appendicitis was more common in patients with acute appendicitis after the outbreak of the 2019-nCoV epidemic.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Complicated appendicitis are common during the epidemic period of 2019 novel coronavirus (2019-nCoV)

Gao¹,

Li²,

Zhou³

et al. 2020

Asian Journal of Surgery

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“…The majority of our patients were young and middle aged, studies reported that the rate of complications is higher in populations older than 65 years. [7,10] The number of females admitted for acute appendicitis were more than number of males, but the percentage of complicated appendicitis outnumbered those for the females by about 9 folds, 93% for males versus 7% for females, with a very signi cant correlation between complicated appendicitis and the gender (P value 0.000). This may be attributed that the pain threshold in females is less than that of males, so that males presented late, also female may present because of various problems related to ovaries and oviducts.…”

Section: Discussionmentioning

confidence: 99%

Appraisal of Various Predictors for Complicated Appendicitis in Adults; A Comparative Study Between Complicated and Non-Complicated Appendicitis

Mohammed

2021

Preprint

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Background: Acute appendicitis is the most common non traumatic surgical abdominal emergency, and is the first operation done by most of the general surgeon during their training period. The most important aspect in the management of acute appendicitis, is early diagnosis and intervention to avoid the development of complications.Patients and methods: This prospective study included 184 patients diagnosed with acute appendicitis who were grouped into complicated and non- complicated appendicitis. Both groups were compared to detect predictors for complicated appendicitis to prevent delay management. Results: About 82.6% of our patients were below 30 years (mean: 23.8 years) and 59.2% were females. Histopathology confirmed acute appendicitis in 86.5 %, chronic appendicitis in 12.5%, and normal appendix in 1.1%. About 81.5% have ALVARADO score equal or greater than 7. Complicated appendicitis was diagnosed in 23.37% of patients. There was a significant correlation between complicated appendicitis and gender, rebound tenderness, elevated temperature, elevated WBC, shift to left of WBC and Modified Alvarado Scoring (P values 0.000,0.002,0.001,0.000,0.000, and 0.006), other parameters showed no significant correlations. Conclusion: The rate of complicated appendicitis should be reduced to decrease the associated morbidity, the presence of rebound tenderness, fever, high WBC count and sift to left, a score of 7 or more by modified ALVAADO score, and male sex are highly suggestive. The presence of these factors mandates early and prompt intervention.

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“…Acute appendicitis is one of the major diseases that has been addressed by many studies to elevate diagnostic accuracy since it has a unsteady clinical course and progressive nature that may lead to high morbidity and mortality rates in the elderly population when remains untreated [5,6,15]. The low diagnostic accuracy based on clinical findings and longer time interval before hospital admission in elderly patient group than younger patient group increase probability of perforation and progression to complicated appendicitis and consequently increase the use of imaging techniques such as Computed Tomography [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

“…than normal population in cases of delayed diagnosis make this emergency condition more critical and necessitate development of novel adjuvant diagnostic methods [4,5]. Even though, numerous studies have been carried out to predict clinical course and treatment method (medical/surgical) of the disease in the patients with AA in the recent years, clinical course and findings of the disease may vary in the elderly patient group and pose a necessity for further studies in this patient group [5,6]. Although, diagnostic laboratory and imaging methods reduced negative appendectomy rates, several complete blood count (CBC) parameters such as red blood cell width (RDW),…”

Section: Am J Biomed Sci and Resmentioning

confidence: 99%

Can Red Cell Distribution Width and Neutrophil/ Lymphocyte Ratio Be Used as Adjuvant Parameters to Support Computed Tomography in Prediction of Diagnosis and Severity of Acute Appendicitis in the Elderly Patients?

Atabey

2021

AJBSR

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Unexpected complicated appendicitis in the elderly diagnosed with acute appendicitis

Cited by 18 publications

References 17 publications

Complicated appendicitis are common during the epidemic period of 2019 novel coronavirus (2019-nCoV)

Complicated appendicitis are common during the epidemic period of 2019 novel coronavirus (2019-nCoV)

Appraisal of Various Predictors for Complicated Appendicitis in Adults; A Comparative Study Between Complicated and Non-Complicated Appendicitis

Can Red Cell Distribution Width and Neutrophil/ Lymphocyte Ratio Be Used as Adjuvant Parameters to Support Computed Tomography in Prediction of Diagnosis and Severity of Acute Appendicitis in the Elderly Patients?

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