Clinical Predictors for Ruptured Appendicitis in Acute Appendicitis Patients
Keywords:
clinical predictors, ruptured appendicitis, acute appendicitisAbstract
Background: Acute appendicitis is a most common surgical condition and requires emergency surgery. Atypical clinical manifestation and missed diagnosis can lead ruptured appendicitis resulting in increasing morbidity and mortality.
Objective: To identify clinical appearance for predicting the ruptured appendicitis in acute appendicitis patients.
Materials and Methods: A retrospective cohort study included all patients who underwent appendectomy for acute appendicitis in Thasala hospital from 1st January 2019 to 30th September 2021, were confirmed by intraoperative finding and postoperative pathological results. Patients were divided into ruptured appendicitis and non-ruptured appendicitis. Demographic data, clinical presentation and laboratory results were collected and analyzed to determine clinical predictors for ruptured appendicitis.
Results: 659 patients with appendicitis were included in the study. 83 patients (12.6%) were ruptured appendicitis. Patients with ruptured appendicitis were significantly had duration of symptoms longer than 48 hours (adjusted OR=36.31, p<0.001), anorexia (adjusted OR=3.48, p=0.002), body temperature >38ºC (adjusted OR=2.79, p=0.005), localized guarding on abdominal examination(adjusted OR=2.28, p=0.019),complete blood count showed WBC>14,000 (adjusted OR=2.81, p=0.008) and neutrophil count>80% (adjusted OR=2.39, p=0.02) as independent factors for ruptured appendicitis.
Conclusions: Clinical predictors from this study can predict the risk of ruptured appendicitis. It can also be used as a guideline for decision making in referral patient, appropriate treatment and informing the patient and their families.
Keywords: clinical predictors, ruptured appendicitis, acute appendicitis
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เนื้อหาและข้อมูลในบทความที่ลงตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นข้อคิดเห็นและความรับผิดชอบของผู้เขียนบทความโดยตรงซึ่งกองบรรณาธิการวารสาร ไม่จำเป็นต้องเห็นด้วย หรือร่วมรับผิดชอบใด ๆ
บทความ ข้อมูล เนื้อหา รูปภาพ ฯลฯ ที่ได้รับการตีพิมพ์ในมหาราชนครศรีธรรมราชเวชสาร ถือเป็นลิขสิทธิ์ของมหาราชนครศรีธรรมราชเวชสาร หากบุคคลหรือหน่วยงานใดต้องการนำทั้งหมดหรือส่วนหนึ่งส่วนใดไปเผยแพร่ต่อหรือเพื่อกระทำการใด จะต้องได้รับอนุญาตเป็นลายลักษณ์อักษรจากวารสารมหาราชนครศรีธรรมราชเวชสาร ก่อนเท่านั้น
