Format

Send to

Choose Destination
Ulus Travma Acil Cerrahi Derg. 2019 Mar;25(2):129-136. doi: 10.5505/tjtes.2018.80103.

Complicated appendicitis: Risk factors and outcomes of laparoscopic appendectomy - Polish laparoscopic appendectomy results from a multicenter, large-cohort study.

Author information

1
2nd Department of General Surgery, Jagiellonian University Medical College, Kraków-Poland.
2
Center for Research, Training and Innovation in Surgery (CERTAIN Surgery), Kraków-Poland.
3
1st Department of General and Endocrinological Surgery, Medical University of Bialystok, Bialystok-Poland.
4
Department of Surgical Oncology, Medical University of Gdansk, Gdansk-Poland.
5
Department of General, Visceral and Transplant Surgery, Ludwig Maximilian University, Munich-Germany.
6
Department of General, Minimally Invasive and Elderly Surgery, University of Warmia and Mazury, Olsztyn-Poland.
7
Department of General Surgery and Surgical Oncology, Specialist Hospital in Kościerzyna, Kościerzyna-Poland.
8
Department of General, Oncological and Geriatric Surgery, Jagiellonian University Medical College, Krakow-Poland.
9
2nd Department of General, Vascular and Oncological Surgery, Medical University of Warsaw, Second Faculty of Medicine, Warsaw-Poland.
10
Polish Laparoscopic Appendectomy Collaborative Study Group.

Abstract

BACKGROUND:

Preoperative classification of complicated and uncomplicated appendicitis (AA) is challenging. However, the differences in surgical outcomes necessitate the establishment of risk factors in developing, complicated AA. This study was an analysis of the clinical outcomes of laparoscopic appendectomies (LA), as well as preoperative risk factors for the development of complicated AA.

METHODS:

The data of 618 patients who underwent LA in 18 surgical units across Poland and Germany were collected in an online web-based database created by the Polish Videosurgery Society. The surgical outcomes of patients with complicated and uncomplicated appendicitis were compared. Uni- and multivariate logistic regression models were used to establish risk factors for the development of complicated appendicitis.

RESULTS:

In all, 1269 (27.5%) patients underwent LA for complicated appendicitis (Group 1) and 3349 (72.5%) for uncomplicated appendicitis (Group 2). The conversion rate, number of intra-operative adverse events, re-intervention rate, postoperative complications, and readmission rate was greater in Group 1. The preoperative risk factors associated with complicated appendicitis were: female sex (Odds ratio [OR]: 1.58), obesity (OR: 1.51), age >50 years (OR: 1.51), symptoms >48 hours (OR: 2.18), high Alvarado score (OR: 1.29 with every point), and C-reactive protein level >100 mg/L (OR: 3.92).

CONCLUSION:

Several demographic and clinical risk factors for complicated AA were identified. LA for complicated appendicitis was associated with poorer outcomes.

PMID:
30892680
DOI:
10.5505/tjtes.2018.80103
Free full text

Supplemental Content

Full text links

Icon for LookUs Bilisim
Loading ...
Support Center