Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study

Lasek, Anna; Wysocki, Michał; Su, Michael; Bobowicz, Maciej; Myśliwiec, Piotr; Astapczyk, Kamil; Burdzel, Mateusz; Chruściel, Karolina; Cygan, Rafał; Czubek, Wojciech; Dowgiałło-Wnukiewicz, Natalia; Droś, Jakub; Franczak, Paula; Hołówko, Wacław; Kacprzyk, Artur; Karcz, Wojciech Konrad; Kenig, Jakub; Konrad, Paweł; Kopiejć, Arkadiusz; Kot, Adam; Krakowska, Karolina; Kukla, Maciej; Leszko, Agnieszka; Łozowski, Leszek; Major, Piotr; Makarewicz, Wojciech; Malinowska-Torbicz, Paulina; Matyja, Maciej; Michalik, Maciej; Niekurzak, Adam; Nowiński, Damian; Ostaszewski, Radomir; Pabis, Małgorzata; Polańska-Płachta, Małgorzata; Rubinkiewicz, Mateusz; Stefura, Tomasz; Stępień, Anna; Szabat, Paweł; Śmiechowski, Rafał; Tomaszewski, Sebastian; Ehrlich-Treuenstätt, Viktor von; Wasilczuk, Maciej; Wierdak, Mateusz; Wojdyła, Anna; Wroński, Jan Wojciech; Zwolakiewicz, Leszek; Pędziwiatr, Michał

doi:10.1038/s41598-019-51172-2

Cited by 37 publications

(41 citation statements)

References 38 publications

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“…These reasons also prolong the hospitalization period of the patients. In this study, it was also reported that the hospital stay was longer in the CA group, which is consistent with the previous studies [ 19 , 20 ].…”

Section: Discussionsupporting

confidence: 93%

Efficacy of Preoperative Imaging Features and Blood Tests in Predicting the Increased Risk of Conversion in Laparoscopic Appendectomy Surgery

Yiğit¹,

Cerekci²,

Cakir³

et al. 2021

Cureus

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Background In this study, we identified preoperative risk factors, including imaging features and blood tests, to predict conversion from laparoscopic appendectomy to open appendectomy. Thus, we aimed to prevent patients from being exposed to the risks of laparoscopy by choosing patients for whom proceeding directly to an open surgery as an initial approach was appropriate. Patients and methods The cohort of 632 patients who underwent laparoscopic appendectomy due to acute appendicitis in our center between January 2017 and March 2021 were analyzed, and 521 of these patients comprised the study population. Baseline characteristics, medical history, preoperative laboratory tests, imaging features, and postoperative pathologic findings of all patients according to groups who underwent laparoscopic appendectomy or conversion to open appendectomy were examined. Results Among 521 patients, the appendectomy procedure was completed laparoscopically in 498 (95.6%) patients, and conversion to open appendectomy was occurred in 23 (4.4%) patients. 223 (42.8%) patients were female, and 298 (57.2%) patients were male. The mean age of all patients was 35.17±12.61 years (range, 16-80 years). Preoperative ultrasonography feature associated with a higher rate of conversion was free fluid collection (p=0.001). The levels of C-reactive protein, neutrophil, and neutrophil/lymphocyte ratio on admission were found to be significantly higher in the conversion group compared to the laparoscopy group (p=0.001, p=0.027, p=0.02, respectively). Conclusions Free fluid collection detected by ultrasonography, and elevation of C-reactive protein, neutrophil, and neutrophil/lymphocyte ratio may be useful in the prediction of a high risk of conversion appendectomy. Despite the unquestionable advantages of laparoscopic surgery, there are still substantial conversion rates. Within this framework, our study will help the surgeons to choose the most appropriate surgical methods for patients by evaluating them individually, and to inform them of the possibility of conversion to the open approach, and other risks before surgery.

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Section: Discussionsupporting

confidence: 93%

Efficacy of Preoperative Imaging Features and Blood Tests in Predicting the Increased Risk of Conversion in Laparoscopic Appendectomy Surgery

Yiğit¹,

Cerekci²,

Cakir³

et al. 2021

Cureus

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“…A multicentered large cohort study in Poland also showed that appendicitis (through the Alvarado score) has a significant relationship with the length of stay (OR, 1.10; p =0.008). Similar relations to the length of stay were also found on symptom onset before the surgery (OR, 1.72; p <0.001), diabetes (OR, 3.96; p <0.001), and old age (OR, 2.78; p <0.001) [ 34 ].…”

Section: Discussionmentioning

confidence: 53%

Pre-Coronavirus Disease 2019 Pediatric Acute Appendicitis: Risk Factors Model and Diagnosis Modality in a Developing Low-Income Country

Salim

Agustina

Maker

2022

Pediatr Gastroenterol Hepatol Nutr

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Purpose Pediatric acute appendicitis has a stable incidence rate in Western countries with an annual change of -0.36%. However, a sharp increase was observed in the Asian region. The Indonesian Health Department reveals appendicitis as the fourth most infectious disease, with more than 64,000 patients annually. Hence, there is an urgent need to identify and evaluate the risk factors and diagnostic modalities for accurate diagnosis and early treatment. This study also clarifies the usage of pediatric appendicitis score (PAS) for children <5 years of age. Methods The current study employed a cross-sectional design with purposive sampling through demographic and PAS questionnaires with ultrasound sonography (USG) results. The analysis was performed using the chi-square and Mann–Whitney tests and logistic regression. Results This study included 21 qualified patients with an average age of 6.76±4.679 years, weighing 21.72±10.437 kg, and who had been hospitalized for 4.24±1.513 days in Siloam Teaching Hospital. Compared to the surgical gold standard, PAS and USG have moderate sensitivity and specificity. Bodyweight and stay duration were significant for appendicitis ( p <0.05); however, all were confounders in the multivariate regression analysis. Incidentally, a risk prediction model was generated with an area under the curve of 72.73%, sensitivity of 100.0%, specificity of 54.5%, and a cut-off value of 151. Conclusion PAS outperforms USG in the sensitivity of diagnosing appendicitis, whereas USG outperforms PAS in terms of specificity. This study demonstrates the use of PAS in children under 5 years old. Meanwhile, no risk factors were significant in multivariate pediatric acute appendicitis risk factors.

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“…It is worth mentioning that some researchers have also focused on the impact of LOS on readmission. For example, in the study of laparoscopic appendectomy, a prolonged LOS is an influencing factor of postoperative adverse events such as readmission and clinical endpoints (Walędziak et al, 2019). The proportion of patients readmitted to the ICU within 30 days would, in turn, affect the LOS (Long & Mathews, 2018).…”

Section: Results Of the Hfs-lightgbmmentioning

confidence: 99%

HFS‐LightGBM: A machine learning model based on hybrid feature selection for classifying ICU patient readmissions

et al. 2020

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Compared to patients readmitted to general wards, readmitted patients in the intensive care unit (ICU) are exposed to higher mortality rates and prolonged hospital stays. Moreover, the readmission of ICU patients brings pressing challenges for ICU management. Most models are devoted to identifying the risk factors and developing classification models that can predict whether ICU patients will be readmitted. Though these models are prominent, they do not provide estimates for the frequency of readmissions. This paper establishes a prediction model, hybrid feature selection‐LightGBM (HFS‐LightGBM), to evaluate the probability and frequency of ICU patient readmissions empirically. In terms of feature selection, a hybrid feature selection (HFS) algorithm for LightGBM combines the filter and wrapper methods. Pearson's correlation coefficient is employed in the filter procedure. Then we adopt the targeted LightGBM classifier along with the recursive feature elimination and cross‐validated (RFECV) to produce the optimal feature subset. Additionally, the hyperparameters of the HFS‐LightGBM are optimized. The HFS‐LightGBM is employed on the real‐world ICU dataset containing 1722 patients' electronic health records. This model outperforms the current prevailing readmission models. The identified frequency can assist doctors in making specific interventions for patients to reduce the ICU readmission rate.

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Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study

Cited by 37 publications

References 38 publications

Efficacy of Preoperative Imaging Features and Blood Tests in Predicting the Increased Risk of Conversion in Laparoscopic Appendectomy Surgery

Efficacy of Preoperative Imaging Features and Blood Tests in Predicting the Increased Risk of Conversion in Laparoscopic Appendectomy Surgery

Pre-Coronavirus Disease 2019 Pediatric Acute Appendicitis: Risk Factors Model and Diagnosis Modality in a Developing Low-Income Country

HFS‐LightGBM: A machine learning model based on hybrid feature selection for classifying ICU patient readmissions

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