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Predictive Factors to Distinguish Between Patients With Noncomplicated Appendicitis and Those With Complicated Appendicitis.

Kim TH, Cho BS, Jung JH, Lee MS, Jang JH, Kim CN - Ann Coloproctol (2015)

Bottom Line: In the univariate analysis, the appendicocecal junction's diameter, appendiceal maximal diameter, appendiceal wall enhancement, periappendiceal fat infiltration, ascites, abscesses, neutrophil proportion, C-reactive protein (CRP), aspartate aminotransferase, and total bilirubin were statistically significant factors.However, in the multivariate analysis, the appendiceal maximal diameter (P = 0.018; odds ratio [OR], 1.129), periappendiceal fat infiltration (P = 0.025; OR, 5.778), ascites (P = 0.038; OR, 2.902), and CRP (P < 0.001; OR, 1.368) were statistically significant.Several factors can be used to distinguish between noncomplicated and complicated appendicitis.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.

ABSTRACT

Purpose: Recently, randomized controlled trials have reported that conservative therapy can be a treatment option in patients with noncomplicated appendicitis. However, preoperative diagnosis of noncomplicated appendicitis is difficult. In this study, we determined predictive factors to distinguish patients with noncomplicated appendicitis from those with complicated appendicitis.

Methods: A total of 351 patients who underwent surgical treatment for acute appendicitis from January 2011 to December 2012 were included in this study. We classified patients into noncomplicated or complicated appendicitis groups based on the findings of abdominal computed tomography and pathology. We performed a retrospective analysis to find factors that could be used to discriminate between noncomplicated and complicated appendicitis.

Results: The mean age of the patients in the complicated appendicitis group (54.5 years) was higher than that of the patients in the noncomplicated appendicitis group (40.2 years) (P < 0.001), but the male-to-female ratios were similar. In the univariate analysis, the appendicocecal junction's diameter, appendiceal maximal diameter, appendiceal wall enhancement, periappendiceal fat infiltration, ascites, abscesses, neutrophil proportion, C-reactive protein (CRP), aspartate aminotransferase, and total bilirubin were statistically significant factors. However, in the multivariate analysis, the appendiceal maximal diameter (P = 0.018; odds ratio [OR], 1.129), periappendiceal fat infiltration (P = 0.025; OR, 5.778), ascites (P = 0.038; OR, 2.902), and CRP (P < 0.001; OR, 1.368) were statistically significant.

Conclusion: Several factors can be used to distinguish between noncomplicated and complicated appendicitis. Using these factors, we could more accurately distinguish patients with noncomplicated appendicitis from those with complicated appendicitis.

No MeSH data available.


Related in: MedlinePlus

Receiver operating characteristics (ROC) curve for the scoring system based on the laboratory data and the computed tomography scans. The area under the ROC curve is 0.870 (95% confidence interval, 0.825-0.915).
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Figure 1: Receiver operating characteristics (ROC) curve for the scoring system based on the laboratory data and the computed tomography scans. The area under the ROC curve is 0.870 (95% confidence interval, 0.825-0.915).

Mentions: In this study, through analysis of preoperative lab data, abdominal CT scans, and postoperative pathology findings, we attempted to provide a diagnostic criterion that could distinguish patients with noncomplicated appendicitis from those with complicated appendicitis. The adopted variables were the appendiceal maximal diameter (>10 mm), periappendiceal fat infiltration, and ascites on CT findings and CRP (>5 mg/dL) (Table 5). One point was assigned to each variable, adding up to a total of four points. The mean score for the complicated appendicitis group (2.63 ± 0.87 points) was significantly higher than that for the noncomplicated appendicitis group (1.17 ± 0.85 points) (P = 0.459). The area under the curve of the receiver operating characteristics curve was shown to be 0.870 (Fig. 1). If we adopted a score of two to diagnose complicated appendicitis, that score had a sensitivity of 0.89 and a specificity of 0.68.


Predictive Factors to Distinguish Between Patients With Noncomplicated Appendicitis and Those With Complicated Appendicitis.

Kim TH, Cho BS, Jung JH, Lee MS, Jang JH, Kim CN - Ann Coloproctol (2015)

Receiver operating characteristics (ROC) curve for the scoring system based on the laboratory data and the computed tomography scans. The area under the ROC curve is 0.870 (95% confidence interval, 0.825-0.915).
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644707&req=5

Figure 1: Receiver operating characteristics (ROC) curve for the scoring system based on the laboratory data and the computed tomography scans. The area under the ROC curve is 0.870 (95% confidence interval, 0.825-0.915).
Mentions: In this study, through analysis of preoperative lab data, abdominal CT scans, and postoperative pathology findings, we attempted to provide a diagnostic criterion that could distinguish patients with noncomplicated appendicitis from those with complicated appendicitis. The adopted variables were the appendiceal maximal diameter (>10 mm), periappendiceal fat infiltration, and ascites on CT findings and CRP (>5 mg/dL) (Table 5). One point was assigned to each variable, adding up to a total of four points. The mean score for the complicated appendicitis group (2.63 ± 0.87 points) was significantly higher than that for the noncomplicated appendicitis group (1.17 ± 0.85 points) (P = 0.459). The area under the curve of the receiver operating characteristics curve was shown to be 0.870 (Fig. 1). If we adopted a score of two to diagnose complicated appendicitis, that score had a sensitivity of 0.89 and a specificity of 0.68.

Bottom Line: In the univariate analysis, the appendicocecal junction's diameter, appendiceal maximal diameter, appendiceal wall enhancement, periappendiceal fat infiltration, ascites, abscesses, neutrophil proportion, C-reactive protein (CRP), aspartate aminotransferase, and total bilirubin were statistically significant factors.However, in the multivariate analysis, the appendiceal maximal diameter (P = 0.018; odds ratio [OR], 1.129), periappendiceal fat infiltration (P = 0.025; OR, 5.778), ascites (P = 0.038; OR, 2.902), and CRP (P < 0.001; OR, 1.368) were statistically significant.Several factors can be used to distinguish between noncomplicated and complicated appendicitis.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.

ABSTRACT

Purpose: Recently, randomized controlled trials have reported that conservative therapy can be a treatment option in patients with noncomplicated appendicitis. However, preoperative diagnosis of noncomplicated appendicitis is difficult. In this study, we determined predictive factors to distinguish patients with noncomplicated appendicitis from those with complicated appendicitis.

Methods: A total of 351 patients who underwent surgical treatment for acute appendicitis from January 2011 to December 2012 were included in this study. We classified patients into noncomplicated or complicated appendicitis groups based on the findings of abdominal computed tomography and pathology. We performed a retrospective analysis to find factors that could be used to discriminate between noncomplicated and complicated appendicitis.

Results: The mean age of the patients in the complicated appendicitis group (54.5 years) was higher than that of the patients in the noncomplicated appendicitis group (40.2 years) (P < 0.001), but the male-to-female ratios were similar. In the univariate analysis, the appendicocecal junction's diameter, appendiceal maximal diameter, appendiceal wall enhancement, periappendiceal fat infiltration, ascites, abscesses, neutrophil proportion, C-reactive protein (CRP), aspartate aminotransferase, and total bilirubin were statistically significant factors. However, in the multivariate analysis, the appendiceal maximal diameter (P = 0.018; odds ratio [OR], 1.129), periappendiceal fat infiltration (P = 0.025; OR, 5.778), ascites (P = 0.038; OR, 2.902), and CRP (P < 0.001; OR, 1.368) were statistically significant.

Conclusion: Several factors can be used to distinguish between noncomplicated and complicated appendicitis. Using these factors, we could more accurately distinguish patients with noncomplicated appendicitis from those with complicated appendicitis.

No MeSH data available.


Related in: MedlinePlus