Risk Factors for the Development of Complicated Appendicitis in Adults Publisher



Naderan M¹ ; Babaki AES¹ ; Shoar S¹ ; Mahmoodzadeh H¹ ; Nasiri S¹ ; Khorgami Z¹ Show Affiliations
Source: Turkish Journal of Surgery Published:2016

Abstract

Objective: To investigate the patient's history and physical examination information to find out risk factors associated with complicated appendicitis. Material and Methods: Two hundred patients who were admitted with complicated appendicitis (including abscess, phlegmon, and generalized peritonitis) were retrieved from our database. Two hundred patients with non-complicated acute appendicitis were randomly selected from the same period. These two groups were compared in terms of demographic characteristics, past medical history, and presenting symptoms. We made a multivariate analysis model using binary logistic regression and backward stepwise elimination. Results: Based on multivariate analysis, risk factors for complicated appendicitis included presenting with epigastric pain (OR=3.44), diarrhea (OR=23.4) or malaise (OR=49.7), history of RLQ pain within the past 6 months (OR=4.93), older age (OR=1.04), being married (OR=2.52), lack of anorexia (OR=4.63) and longer interval between onset of symptoms and admission (OR=1.46). Conversely, higher (academic) education was associated with decreased odds for complicated appendicitis (OR=0.26). Conclusion: Our findings suggest that a surgeon's clinical assessment is more reliable to make a judgment. Bedside evaluation is a useful, cheap, quick and readily available method for identifying those at risk for developing complicated acute appendicitis. © Copyright 2016 by Turkish Surgical Association.