Diagnostic Accuracy in 2,351 Patients Undergoing Appendicectomy for Suspected Acute Appendicitis: A Retrospective Study 1986–1993

Styrud, Johan; Eriksson, S; Segelman, Josefin; Granström, L

doi:10.1159/000018692

Cited by 30 publications

(23 citation statements)

References 9 publications

(13 reference statements)

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“…This is in accordance with a recent large population based study from Sweden [19], as well as a perforation rate of 20% [20]. These reports reflect a more conservative attitude to the decision as to operate or not in patients with suspected acute appendicitis, resulting in a decreased appendectomy rate.…”

Section: Discussionsupporting

confidence: 91%

Stability in Incidence of Acute Appendicitis

Kørner

Søreide²,

Pedersen

et al. 2001

Dig Surg

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Background/Aim of the Study: During the past 50 years, a decrease in incidence of appendicitis has been reported. The various studies were retrospective and based on different data sources. In the present study, we analyze prospectively the incidence of acute appendicitis during a 10-year period in a well defined population of 265,000. Methods: Prospective registration of all operations performed in patients with suspected acute appendicitis in the catchment area of a single institution. The diagnosis of acute appendicitis was based on histology in all cases. The annual incidence of acute appendicitis was calculated with regard to nonperforated and perforated acute appendicitis. Main Results: Between 1989 and 1998, 2,861 patients underwent surgery for suspected acute appendicitis. In 2,232 (78%) patients, acute appendicitis was confirmed histologically. Mean annual incidence was 84/100,000 (95% confidence interval 80 to 88/100,000). Crude incidence remained stable during the study period, with the exception of a significant increase in 1991 followed by a significant decrease the next year. Nonperforated acute appendicitis showed a different incidence pattern as compared to perforated acute appendicitis. Conclusion: In our prospective study, the incidence of acute appendicitis remained stable in our well-defined study population during the study period of 10 years. This is in contrast to the majority of studies during the last decades.

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Section: Discussionsupporting

confidence: 91%

Stability in Incidence of Acute Appendicitis

Kørner

Søreide²,

Pedersen

et al. 2001

Dig Surg

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show abstract

“…Though the mortality rate is 2 to 4% till now due to this disease and its complications, the rate of misdiagnosis in patients may be upto 40%. [2][3][4][5][6][7] Despite technologic advances, the diagnosis of appendicitis is still based primarily on the patient's history and the physical examination. 8 This relatively high rate of unnecessary appendicectomy is being challenged while there is dramatic expansion of diagnostic testing options for appendicitis during the last decade.…”

Section: Resultsmentioning

confidence: 99%

Institutional and population based analyses on misdiagnosis of appendicitis in Khulna, Bangladesh

et al. 2017

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The aim of the present study was to identify factors associated with misdiagnosis of appendicitis to propose solutions to decrease the misdiagnosis rate of appendicitis. The study conducted an institutional and a population based analyses on misdiagnosis of appendicitis conducted in Khulna district, Bangladesh. The study dealt with 2 groups of patients. Group 1 consisted of the patients treated in Gazi Medical College Hospital (GMCH), Khulna either in out-patient department (OPD) within the last 3 years (from 2014 to 2016), treating doctors suggested appendicectomy and in indoor-patient department (IPD) within the last 5 years (from 2012 to 2016), the diagnosis was done either during operation or admitted as postoperative complications. Patients for Group 2 were selected purposively from the patients who were from different villages of Rupsha and Fakirhat Upazila or from Khulna city previously underwent appendicectomy within the last 5 years (from 2012 to 2016) in different hospitals other than GMCH, Khulna and previous symptoms were still existed. The study revealed that the majority of the patients were female (OPD 81.5%, IPD 68.8% in Group 1 and 83.2% in Group 2). The misdiagnosis rate of appendicitis for the patients attended GMCH OPD and GMCH IPD was 23.0% and 8.9%, respectfully. The overall misdiagnosis rate of appendicitis for the patients attended GMCH was 14.0%. In case of the patients attended GMCH OPD, most of them had UTI and chronic cystitis (45.5%). In case of the patients attended GMCH IPD, most of them had non-inflamed appendix (84.4%). The misdiagnosis rate of appendicitis for the patients in Group 2 was 23.2%. Some factors were identified and bearing in mind the factors, all the concerned should be more careful and conscious while making the diagnosis of appendicitis to avoid misdiagnosis and patients’ suffering.Mediscope Vol. 4, No. 2: Jul 2017, Page 29-34

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“…Some reports indicate a higher risk for intestinal obstruction following surgery for a normal appendix compared with that for a non-perforated inflamed appendix [12,13]. The risk for intestinal obstruction is increased by up to 5% in patients with a healthy appendix [14].…”

Section: Discussionmentioning

confidence: 99%

Serum Biomarkers As a Diagnostic Aid in Acute Appendicitis

Jairaj

Narendranath

Ali

et al. 2016

Int J of Biomed & Adv Res

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Background: Acute appendicitis is one of the most common acute intra-abdominal infections seen in surgical departments, which can be treated easily if an accurate diagnosis is made on time. Otherwise, delay in diagnosis and treatment can lead to perforation of the appendix &diffuse peritonitis. Materials and Methods: A prospective study was conducted on 112 patients who were operated for acute appendicitis in department of General surgery, Bowring & Lady Curzon Hospitals, BMCRI, to determine the role and predictive value of the total leucocyte count (TLC), C-reactive protein (CRP) and percentage of neutrophil count in the diagnosis of acute appendicitis. Preoperative TLC, CRP and percentage of neutrophil count were determined and were compared with the results of the histopathology of the removed appendix. Results: Of all the patients studied, 94 had histopathologically positive appendicitis. The TLC was found to be significantly high in 82 patients who proved to have acute appendicitis, whereas CRP was high in 88 patients and neutrophil percentage was raised in 87 patients; 6 patients had a normal CRP level. Thus, TLC had a sensitivity, specificity &positive predictive value of 87.23%, 44.44% and 89.13% respectively. CRP had a sensitivity, specificity & positive predictive value of 93.61%, 77.77% and 95.65% respectively. Percentage of neutrophil count had a sensitivity, specificity & positive predictive value of 92.55%, 38.88%, 88.77% respectively. When used in combination, there was a marked improvement in the sensitivity, specificity and the positive predictive value to98.76%, 86.66% and 97.56% respectively. Conclusion: The inflammatory markers, i.e., TLC, CRP and neutrophil count can be helpful in the diagnosis when measured together as this increases their sensitivity, specificity & positive predictive value significantly.

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Diagnostic Accuracy in 2,351 Patients Undergoing Appendicectomy for Suspected Acute Appendicitis: A Retrospective Study 1986–1993

Cited by 30 publications

References 9 publications

Stability in Incidence of Acute Appendicitis

Stability in Incidence of Acute Appendicitis

Institutional and population based analyses on misdiagnosis of appendicitis in Khulna, Bangladesh

Serum Biomarkers As a Diagnostic Aid in Acute Appendicitis

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