Assessment of demographic, clinical, and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis

Akbulut, Sami; Bahçe, Zeynep Şener; Öztaş, Tülin; Gümüş, Serdar; Söğütçü, Nilgün; Sakarya, Hamdi; Gök, Ali Fuat Kaan; Yağmur, Yusuf

doi:10.14744/tjtes.2020.73537

Cited by 10 publications

(15 citation statements)

References 21 publications

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“…The greater use of CT imaging during the pandemic is likely to explain the lower negative appendicectomy rate seen during the pandemic. Outside of the pandemic, a negative appendicectomy rate of 9.7% was reported in a retrospective study of 8206 patients [ 28 ], which is consistent with what is widely reported in the literature. In our cohort, the negative appendicectomy rate nearly halved during the pandemic to 5.7%, whilst the rate of CT prior to operation increased by approximately 10%.…”

Section: Discussionsupporting

confidence: 85%

Management of acute appendicitis during the COVID-19 pandemic: a retrospective cohort study

et al. 2022

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Background The Coronavirus Disease 2019 (COVID-19) pandemic profoundly impacted delivery of health care. South Western Sydney Local Health District (SWSLHD) experienced some of the highest cases, admissions and deaths during the Delta and Omicron waves in New South Wales. This study aims to determine the impact of the pandemic on emergency surgery services for adults presenting with acute appendicitis. Methods A retrospective review of patient records was performed of adults presenting with acute appendicitis between 1st March 2021 and 31st March 2022, which was compared to a pre-COVID control period of the same dates in 2019–2020. Patients managed operatively or conservatively were included. Results 1556 patients were included in the operative arm; 723 and 833 respectively in the study and control groups, which were comparable at baseline. 1.66% were COVID positive. During the pandemic, patients were significantly more likely to be investigated with computered tomography (CT) scan (p ≤ 0.001), present with complicated appendicitis (p = 0.03), and require caecectomy (p = 0.005). They had higher American Society of Anaesthesiology (ASA) scores (p = 0.001) and significantly lower negative appendectomy rates (p = 0.001). Fifty-two patients were included in the conservative arm; 29 and 23 respectively in the pandemic and control groups. Patients were comparable at baseline. There were two COVID positive patients. During the pandemic, there was a significant reduction in complications (p = 0.033), readmissions (0.044) and interval appendicectomy (p = 0.0044). Conclusion We identified higher rates of complicated appendicitis, caecectomies and greater reliance on CT imaging preoperatively during the pandemic in SWSLHD.

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Section: Discussionsupporting

confidence: 85%

Management of acute appendicitis during the COVID-19 pandemic: a retrospective cohort study

et al. 2022

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“…Akbulut et al, suggested that a relationship exists between demographic features, histopathological findings of appendectomy specimens, seasons, days of the week, and working days in patients undergoing appendectomy [ 14 ]. Meanwhile the current study, focused on the surgical approach, fund that patients in the laparoscopic group had significantly higher operative time (74.32 ± 1.12) compared to patients in the open surgery group (47.86 ± 3.31) (p < 0.001).…”

Section: Resultsmentioning

confidence: 99%

Outcome and quality of life in obese patients underwent laparoscopic vs. open appendectomy

et al. 2022

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Background Although obesity is a popular reason for choosing laparoscopic appendectomy (LA) versus open appendectomy (OA), however, the question of whether there is a difference remains. Our goal is to investigate if there is a difference between OA and LA in obese patients. Methods Fifty-eight obese patients diagnosed with acute appendicitis according to ALVARDO score at department of surgery at Suez Canal university hospitals from March 2020 till August 2021 were included. The study participants were assigned in two groups LA and OA. This study aimed to comparing between LA and OA regarding intraoperative complications, length of hospital stays, post -operative pain, and rate of post-operative complications. Meanwhile, using SF-36 scoring questionnaire, the quality of life was compared between both groups. Results A total of 58 patients were included in the present study (LG = 29 patients and OG = 29 patients). The early post-operative complications (within 30 days after surgery) were significantly lower in the LA group (5 patients out of 29) than the OA (11 patients out of 29). Additionally, lower incidence of complications was noticed in the LA group (2 out of 29 patients) compared to OA (6 patients out of 29) beyond 30 days after operation. Patients with laparoscopic surgery had statistically significant higher overall quality of life scores (SF-36) (72 ± 32) compared to open surgery patients (66 ± 35) 2 weeks after operation. Conclusion The laparoscopic procedure was associated with lower incidence of post operative complications. However, open appendectomy was superior for a shorter operative time. Laparoscopic approach is not only used for therapeutic purposes, but also it has a diagnostic role.

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“…AA occurs year-round, but certain months have higher rates. Some authors have linked AA, demographics, and seasons 7 .…”

Section: Introductionmentioning

confidence: 99%

A systematic review and meta-regression for validation of the Alvarado score as a tool for predicting acute appendicitis

Gupta

Kolli

Costa

et al. 2023

Annals of Medicine &Amp; Surgery

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Background: The Alvarado score (AS) has not been widely used for diagnosing acute appendicitis although it has shown to be a good predictor for diagnosing appendicitis. The aim was to perform a systematic review of the available literature and synthesize the evidence. Methods: A systematic review was performed as per the PRISMA guidelines using search engines like Ovid, PubMed, and Google Scholar with predefined, strict inclusion and exclusion criteria. The quality assessment of included studies was performed using the QUADAS 2 tool. Summary statistics were performed for all variables. A linear regression model was performed between dependent and independent variables using STATA software. Heterogeneity testing showed significant heterogeneity within the included studies; hence, a forest plot with pooled estimates could not be constructed, and therefore a meta-regression was performed. Results: Seventeen full-text articles met inclusion and exclusion criteria. Ten of which were identified as low-risk studies. Five studies were included in final data pooling with total patients being 2239 and mean age of 31.9 years. (1) Linear regression demonstrated an association between ‘histological appendicitis’ and ‘AS 7–0’ with patients receiving intervention, with a significant P value of less than 0.005. (2) Meta-regression demonstrated a positive coefficient (0.298), a positive Z score of 2.20 with a significant P value of 0.028 for patients with ‘high AS’ who received interventions that were significantly proven to be ‘histologically appendicitis’, indicating a cause-and-effect relationship. Conclusion: High AS (7 and above) is a significant predictor of acute appendicitis. The authors recommend further prospective randomized clinical trials to establish a cause-and-effect relationship.

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Assessment of demographic, clinical, and histopathological features of patients who underwent appendectomy due to a presumed diagnosis of acute appendicitis

Cited by 10 publications

References 21 publications

Management of acute appendicitis during the COVID-19 pandemic: a retrospective cohort study

Management of acute appendicitis during the COVID-19 pandemic: a retrospective cohort study

Outcome and quality of life in obese patients underwent laparoscopic vs. open appendectomy

A systematic review and meta-regression for validation of the Alvarado score as a tool for predicting acute appendicitis

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