Are there reliable indicators predicting post-operative complications in acute appendicitis?

被引:12
|
作者
Obayashi, Juma [1 ]
Ohyama, Kei [1 ]
Manabe, Shutaro [1 ]
Tanaka, Kunihide [1 ]
Nagae, Hideki [1 ]
Shima, Hideki [1 ]
Furuta, Shigeyuki [1 ]
Wakisaka, Munechika [1 ]
Kawase, Hirokazu [1 ]
Kitagawa, Hiroaki [1 ]
机构
[1] St Marianna Univ, Div Pediat Surg, Sch Med, Kawasaki, Kanagawa 2168511, Japan
关键词
Acute appendicitis; Complication; Abdominal abscess; Wound infection; PERFORATED APPENDICITIS; RISK-FACTORS; CHILDREN;
D O I
10.1007/s00383-015-3786-9
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
To clarify the predictors of post-operative complications of pediatric acute appendicitis. The medical records of 485 patients with acute appendicitis operated on between January 2006 and November 2014 were retrospectively reviewed. Age, sex, preoperative WBC, CRP, and appendix maximum short diameter on diagnostic imaging (AMSD) were compared retrospectively with the complications group (Group C) vs the non-complication group (Group NC) by Student's T test, Fisher exact test and Multivariate analysis. Regression analysis with p less than 0.01 was considered significant. We analyzed the most recent 314 laparoscopic appendectomy patients similarly. Complications were found in 29 of the 485 appendectomies (6.0 %). Comparing Group C to Group NC, preoperative WBC (x10(3)/mu l) 16.4 +/- A 5.6 vs 14.1 +/- A 4.1 (p < 0.01), CRP (mg/dl) 8.3 +/- A 7.1 vs 3.3 +/- A 4.6 (p < 0.01), AMSD (mm) was 12.1 +/- A 3.7 vs 9.9 +/- A 2.8 (p < 0.01). The CRP was significantly different by Multivariate analysis, but the WBC and AMSD wasn't. The results following laparoscopic appendicectomy data were identical. Preoperative WBC, CPR and AMSD all indicated an increased risk of complications. If WBC (/mu l) > 16,500, CRP > 3.1 mg/dl and AMSD > 11.4 mm, complications increased sixfold.
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页码:1189 / 1193
页数:5
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