Risk factors associated with complications of acute appendicitis

Abstract

Objective : to identify the main risk factors associated with the development of complications in patients with acute appendicitis. Methods: we conducted a case-control study of 402 patients with acute appendicitis hospitalized in a secondary hospital, divided into two groups: the control group, with 373 patients who progressed without postoperative complications (Group 1) and the study group, with 29 patients who presented complications (Group 2). We evaluated demographic data, signs and symptoms of the disease, imaging tests and hospitalization data. Results: factors associated with complications were fever, radiological and sonographic changes, abrupt positive decompression and diarrhea. Migration of pain, nausea, vomiting and abrupt positive decompression were the findings that were significantly more frequent in both groups (p = 0.05). The duration of signs and symptoms in days in group 2 was significantly higher than in group 1, with a median of three days for the group with complications (p = 0.05). Conclusion: alterations in imaging, fever, diarrhea, positive abrupt decompression, duration of symptoms and lower age are associated with a higher frequency of complications in acute appendicitis, which reinforces the importance of anamnesis, physical examination and indication of complementary exams in the approach of these patients.

Risk factors of acute and perforated appendicitis in a semi-rural population: a retrospective study

“…Migration of pain was seen as the most common symptom among the patients which was similar to a study by Naderan et al and Iamarino et al 29,30 Other symptoms als reported by these authors were fever and nausea/vomiting. The serum WBC levels in present study was prominently on the patients with perforated appendix rather than in the non-perforated one.…”

Surgical outcome in patients with complicated appendicitis treated at a medical college hospital

“…26 In another study they found a relationship between the duration of symptoms and the development of complications. 27 The most severe complications of appendicitis are diffuse peritonitis from a perforated appendicitis and intraabdominal abscess. 28 These patients generally require laparotomy and removal of appendix and complete peritoneal lavage.…”

Critério De Alvarado Para Diagnóstico De Apendicite Aguda Infantil

“…O diagnóstico incorreto é mais comum em crianças e idosos, e seu diagnóstico tardio não é muito incomum, devido apresentação atípica na doença com 40% das crianças diagnosticadas incorretamente, por isto se apresenta como desafio aos profissionais. A apendicite descoberta de forma tardia representa progressões patológicas graves, relacionada a complicações sistêmicas, maior tempo de hospitalização, aumento de morbidades e/ou mortalidade, representando maiores custos ao sistema público de saúde, e perda de vidas, onerando assim os serviços de saúde 14 .…”

“…Já no estudo realizado por Iamarino et al 14 , o sintoma mais frequentemente diagnosticado foi a dor migratória, encontrada em 96% dos pacientes que apresentaram apendicite sem complicação e, em 93% dos que apresentaram apendicite com complicação. Entre as complicações, que são decorrentes da evolução do processo inflamatório agudo, os autores citam: supuração, perfuração com ou sem hemorragia e gangrena do apêndice.…”