Predictive factors of negative appendectomy in children

Since delayed diagnosis and treatment of AA are associated with increased length of stay, postoperative complications and mortality, timely intervention is crucial [3-5]. [...]it is important to identify clinical predictive factors of appendicitis in order to reduce negative appendectomy rates. In t...

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Published in:The American journal of emergency medicine 2018-02, Vol.36 (2), p.335-336
Main Authors: Zouari, M., Abid, I., Ben Dhaou, M., Louati, H., Jallouli, M., Mhiri, R.
Format: Article
Language:English
Subjects:
Appendectomy
Appendicitis
Children
Emergency medical care
Mortality
Multivariate analysis
Patients
Pediatrics
Regression analysis
Ultrasonic imaging
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cited_by cdi_FETCH-LOGICAL-c384t-902689c18d6bac91d64fdf91be680de0a1afb7b22448c7188218b12e8e738ad33
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description Since delayed diagnosis and treatment of AA are associated with increased length of stay, postoperative complications and mortality, timely intervention is crucial [3-5]. [...]it is important to identify clinical predictive factors of appendicitis in order to reduce negative appendectomy rates. In the multivariate analysis, a reverse stepwise logistic regression analysis of the data comparing the negative appendectomy and the acute appendicitis groups demonstrated that children with MOD of the appendix on US 5mm. Negative appendectomy Acute appendicitis p Value Odds ratio N % N % Male gender Yes 34 56.7 309 64.4 0.242 0.723 No 26 43.3 171 35.6 Alvarado score
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[...]it is important to identify clinical predictive factors of appendicitis in order to reduce negative appendectomy rates. In the multivariate analysis, a reverse stepwise logistic regression analysis of the data comparing the negative appendectomy and the acute appendicitis groups demonstrated that children with MOD of the appendix on US <=5mm were over eight times more likely to have normal appendix than those with MOD of the appendix >5mm. Negative appendectomy Acute appendicitis p Value Odds ratio N % N % Male gender Yes 34 56.7 309 64.4 0.242 0.723 No 26 43.3 171 35.6 Alvarado score<=5 Yes 38 63.3 142 29.6 <0.001 4.111 No 22 36.7 338 70.4 Temperature<=37.8 °C Yes 24 40 154 32.1 0.219 1.411 No 36 60 326 67.9 Duration of symptoms>=72 h Yes 16 26.7 58 12.1 0.002 2.645 No 44 73.3 422 87.9 WBC count<=10,000/ml Yes 33 55 93 19.4 <0.001 5.086 No 27 45 387 80.6 CRP<=6mg/l Yes 36 60 162 33.7 <0.001 2.944 No 24 40 318 66.3 MOD of the appendix on ultrasound<=5 mm Yes 18 43.9 23 7 <0.001 8.177 No 23 56.1 303 93 1 A.M. Abarbanell, Trends in pediatric appendectomy outcomes, J Surg Res, Vol. 161, 2010, 233-234 2 M. Zouari, M. Jallouli, H. Louati, Predictive value of C-reactive protein, ultrasound and Alvarado score in acute appendicitis: a prospective pediatric cohort, Am J Emerg Med, Vol. 34, Iss. 2, 2016, 189-192 3 R.E. Andersson, Short and long-term mortality after appendectomy in Sweden 1987 to 2006.]]></description><identifier>ISSN: 0735-6757</identifier><identifier>EISSN: 1532-8171</identifier><identifier>DOI: 10.1016/j.ajem.2017.07.075</identifier><identifier>PMID: 28760379</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Appendectomy ; Appendicitis ; Children ; Emergency medical care ; Mortality ; Multivariate analysis ; Patients ; Pediatrics ; Regression analysis ; Ultrasonic imaging</subject><ispartof>The American journal of emergency medicine, 2018-02, Vol.36 (2), p.335-336</ispartof><rights>2017 Elsevier Inc.</rights><rights>Copyright Elsevier Limited 2018</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c384t-902689c18d6bac91d64fdf91be680de0a1afb7b22448c7188218b12e8e738ad33</citedby><cites>FETCH-LOGICAL-c384t-902689c18d6bac91d64fdf91be680de0a1afb7b22448c7188218b12e8e738ad33</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27922,27923</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28760379$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Zouari, M.</creatorcontrib><creatorcontrib>Abid, I.</creatorcontrib><creatorcontrib>Ben Dhaou, M.</creatorcontrib><creatorcontrib>Louati, H.</creatorcontrib><creatorcontrib>Jallouli, M.</creatorcontrib><creatorcontrib>Mhiri, R.</creatorcontrib><title>Predictive factors of negative appendectomy in children</title><title>The American journal of emergency medicine</title><addtitle>Am J Emerg Med</addtitle><description><![CDATA[Since delayed diagnosis and treatment of AA are associated with increased length of stay, postoperative complications and mortality, timely intervention is crucial [3-5]. 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subjects Appendectomy
Appendicitis
Children
Emergency medical care
Mortality
Multivariate analysis
Patients
Pediatrics
Regression analysis
Ultrasonic imaging
title Predictive factors of negative appendectomy in children
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