Acute appendicitis may no longer be a predominant disease of the young population

Pereira, Bruno; Mendes, Cecília Araújo; Ruano, Rafael M; Neves, Ingrid; Curado, Rafael; Oliveira, Rafael de; Beraldo, Giovanni; Matsuguma, Juliana; Horiuchi, Juliana; Dorigatti, Alcir Escócia

doi:10.5114/ait.2019.87332

Cited by 7 publications

(6 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…We could identify six independent risk factors for morbidity: higher age, higher preoperative WBC count, higher preoperative CRP, lower preoperative hemoglobin, longer time to surgery and longer duration of surgery. All these associations are supported by previous studies [11,[19][20][21][22]. Particularly high WBC counts and high CRP values as well as indirectly a longer surgical time are indicators of severe appendicitis, which per se are likely to be associated with higher morbidity.…”

Section: Discussionsupporting

confidence: 78%

Risk factors for postoperative morbidity, prolonged length of stay and hospital readmission after appendectomy for acute appendicitis

Laverde

Maak

Langheinrich

et al. 2023

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

Purpose The aim of the present study was to identify risk factors associated with postoperative morbidity and major morbidity, with a prolonged length of hospital stay and with the need of readmission in patients undergoing appendectomy due to acute appendicitis. Methods We performed a retrospective analysis of 1638 adult patients who underwent emergency appendectomy for preoperatively suspected acute appendicitis from 2010 to 2020 at the University Hospital Erlangen. Data including patient demographics, pre-, intra-, and postoperative findings were collected and compared between different outcome groups (morbidity, major morbidity, prolonged length of postoperative hospital stay (LOS) and readmission) from those patients with verified acute appendicitis (n = 1570). Results Rate of negative appendectomies was 4%. In patients with verified acute appendicitis, morbidity, major morbidity and readmission occurred in 6%, 3% and 2%, respectively. Mean LOS was 3.9 days. Independent risk factors for morbidity were higher age, higher preoperative WBC-count and CRP, lower preoperative hemoglobin, longer time to surgery and longer duration of surgery. As independent risk factors for major morbidity could be identified higher age, higher preoperative CRP, lower preoperative hemoglobin and longer time to surgery. Eight parameters were independent risk factors for a prolonged LOS: higher age, higher preoperative WBC-count and CRP, lower preoperative hemoglobin, need for conversion, longer surgery duration, presence of intraoperative complicated appendicitis and of postoperative morbidity. Presence of malignancy and higher preoperative WBC-count were independent risk factors for readmission. Conclusion Among patients undergoing appendectomy for acute appendicitis, there are relevant risk factors predicting postoperative complications, prolonged hospital stays and readmission. Patients with the presence of the identified risk factors should receive special attention in the postoperative course and may benefit from a more individualized therapy.

show abstract

Section: Discussionsupporting

confidence: 78%

Risk factors for postoperative morbidity, prolonged length of stay and hospital readmission after appendectomy for acute appendicitis

Laverde

Maak

Langheinrich

et al. 2023

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

show abstract

“…As the number of elderly individuals, mostly defined as people over 65 years of age, is continuously increasing in developed countries, acute appendicitis in the elderly and its associated challenges will become more prevalent [ 3 , 4 ]. Thus, the long-prevailing notion that appendicitis is a disease of the young is partly outdated [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Frailty in elderly patients with acute appendicitis

Reinisch¹,

Reichert

Meva

et al. 2022

Eur J Trauma Emerg Surg

View full text Add to dashboard Cite

Purpose Acute appendicitis in the elderly is becoming increasingly recognized for its often severe course. For various elective and urgent operations in older patients, frailty is a risk factor for poor outcomes. However, there is a lack of data on frailty in elderly patients with acute appendicitis. Methods Patients over 65 years old who underwent surgery for acute appendicitis in three hospitals between January 2015 and September 2020 were assessed with the Hospital Frailty Risk Score (HFRS) and the modified Frailty Index (mFI). Outcomes of interest, including morbidity, mortality, and length of stay, were recorded. Results While frailty can be measured with both tests, the mFI has better applicability and takes significantly less time to implement compared to the HFRS (21.6 s vs. 80.3 s, p < 0.0001) while providing the same information value. Patients who exhibited frailty according to either assessment had a significantly higher rate of milder (OR 5.85/2.87, p < 0.0001/0.009) and serious (OR 4.92/3.61, p < 0.011/0.029) complications, more admissions to the intensive care unit (OR 5.16/7.36, p < 0.0001), and an almost doubled length of stay (12.7 days vs. 6.6 days, p < 0.005). Up to 31% of these patients required institutional care after discharge, which is significantly more than those without frailty (p < 0.0001). Furthermore, the mortality rate in frail patients was significantly elevated to 17%, compared to less than 1% in non-frail patients (p = 0.018). Conclusion In elderly patients, frailty is a significant risk factor for negative outcomes. Frailty can be assessed more quickly and reliably with the mFI compared to the HFRS.

show abstract

“…A apendicite é definida como a inflamação do revestimento interno do apêndice vermiforme. Apesar do diagnóstico e avanços terapêuticos, a apendicite continua a ser uma das emergências cirúrgicas mais comuns em todo o mundo (PEREIRA et al, 2019).…”

Section: Introductionunclassified

Apendicite Aguda: Revisão De Literatura

Juremeira

Mantovan

Silva

et al. 2023

REP

View full text Add to dashboard Cite

A apendicite aguda afeta cerca de 10% da população e é, portanto, uma das emergências cirúrgicas mais prevalentes em todo o mundo, representando um importante desafio para os sistemas de saúde. No entanto, a etiologia continua pouco compreendida e o diagnóstico permanece multifatorial. Apesar da disponibilidade de biomarcadores que auxiliam no diagnóstico, a baixa sensibilidade e especificidade limitam seu impacto clínico. O objetivo deste estudo foi avaliar e sintetizar os resultados obtidos a partir de um levantamento bibliográfico sobre essa patologia, onde foram verificadas informações sobre o diagnóstico e quais biomarcadores e tratamentos atuais estão disponíveis. Para isso, foram revisados diversos artigos científicos sobre o tema, demonstrando que, apesar da diversidade de exames e biomarcadores, o diagnóstico da apendicite aguda permanece complexo. A partir dos resultados analisados, foi verificado que nenhum marcador isolado ou outros testes podem identificar a doença com alta especificidade e sensibilidade, indicando a necessidade de mais estudos sobre a combinação desses marcadores para auxiliar no diagnóstico da apendicite aguda. Neste contexto, o tratamento da apendicite consiste na abordagem cirúrgica com apendicectomia aberta ou laparoscópica. No entanto, a antibioticoterapia pode ser o tratamento de escolha em pacientes com apendicite não complicada, demonstrando ser uma medida terapêutica eficaz pela redução das chances de complicações e nas licenças médicas, além da diminuição do uso de medicação para a dor.

show abstract

Acute appendicitis may no longer be a predominant disease of the young population

Cited by 7 publications

References 13 publications

Risk factors for postoperative morbidity, prolonged length of stay and hospital readmission after appendectomy for acute appendicitis

Risk factors for postoperative morbidity, prolonged length of stay and hospital readmission after appendectomy for acute appendicitis

Frailty in elderly patients with acute appendicitis

Apendicite Aguda: Revisão De Literatura

Contact Info

Product

Resources

About