Risk factors associated with perforated acute appendicitis in geriatric emergency patients.

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Risk factors associated with perforated acute appendicitis in geriatric emergency patients.


JournalOpen access emergency medicine: OAEM
Publication date – Oct – 2018
Authors – Tantarattanapong, S; Arwae, N
Keywordsemergency department; geriatric; perforated appendicitis
Open access – Yes
SpecialityEmergency surgery, General surgery
World region South-eastern Asia
Country: Thailand
Language – English
Submitted to the One Surgery Index on October 30, 2018 at 8:29 pm
Abstract:

The aim of this study was to identify factors associated with perforated acute appendicitis in geriatric patients at the emergency department (ED).
The medical records of 223 consecutive patients aged >60 years with acute appendicitis between 2006 and 2017 were retrospectively reviewed. Patients were grouped into those with perforated and non-perforated appendicitis. A comparison was made between the two groups in regard to baseline characteristics, clinical presentation, physical examination, time from onset of symptoms to ED arrival, time from ED arrival to operation, postoperative complications, hospital length of stay, and mortality. Significant factors associated with perforated appendicitis were examined using univariate and multivariate analyses by logistic regression.
A total of 78 (35%) patients had perforated appendicitis. Four significant factors associated with perforated appendicitis were as follows: 1) time duration from onset of symptoms to ED arrival >24 hours (OR 2.49, CI 1.33-4.68); 2) heart rate ≥90 beats/minute (OR 1.93, CI 1.04-3.59); 3) respiratory rate ≥20 breaths/minute (OR 2.54, CI 1.33-4.84); and 4) generalized guarding (OR 12.58, CI 1.43-110.85).
Time duration from onset of symptoms to ED arrival >24 hours, heart rate ≥90 beats/minute, respiratory rate ≥20 breaths/minute, and generalized guarding were the significant factors associated with perforated acute appendicitis in geriatric patients.

OSI Number – 20265
PMID – 30323692

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