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Does the presence of an appendicolith or abscess predict failure of nonoperative management of patients with acute appendicitis?
Purpose Nonoperative management (NOM) has been widely accepted as one of the standard treatments for patients with acute appendicitis. However, predictive factors for the failure of NOM have not been thoroughly investigated. Methods A total of 196 patients with acute appendicitis underwent NOM betwe...
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Published in: | Emergency radiology 2021-10, Vol.28 (5), p.977-983 |
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container_title | Emergency radiology |
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creator | Kohga, Atsushi Kawabe, Akihiro Yajima, Kiyoshige Okumura, Takuya Yamashita, Kimihiro Isogaki, Jun Suzuki, Kenji Muramatsu, Katsuaki |
description | Purpose
Nonoperative management (NOM) has been widely accepted as one of the standard treatments for patients with acute appendicitis. However, predictive factors for the failure of NOM have not been thoroughly investigated.
Methods
A total of 196 patients with acute appendicitis underwent NOM between April 2014 and December 2020. Of these 196 patients, 24 patients failed NOM and required emergency surgery (failure group:
n
= 24), while the other 172 patients were successfully treated with NOM (success group:
n
= 172). These two groups were compared, and the predictive factors for the failure of NOM were investigated.
Results
The number of patients who had a previous history of stroke was significantly increased in the failure group (12.5% vs. 2.9%,
p
= 0.026). Incarceration of an appendicolith on CT images was significantly associated with the failure group (20.8% vs. 1.7%,
p
|
doi_str_mv | 10.1007/s10140-021-01951-0 |
format | article |
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Nonoperative management (NOM) has been widely accepted as one of the standard treatments for patients with acute appendicitis. However, predictive factors for the failure of NOM have not been thoroughly investigated.
Methods
A total of 196 patients with acute appendicitis underwent NOM between April 2014 and December 2020. Of these 196 patients, 24 patients failed NOM and required emergency surgery (failure group:
n
= 24), while the other 172 patients were successfully treated with NOM (success group:
n
= 172). These two groups were compared, and the predictive factors for the failure of NOM were investigated.
Results
The number of patients who had a previous history of stroke was significantly increased in the failure group (12.5% vs. 2.9%,
p
= 0.026). Incarceration of an appendicolith on CT images was significantly associated with the failure group (20.8% vs. 1.7%,
p
< 0.001), while neither the presence of an appendicolith nor abscess was associated. The presence of periappendiceal fluid was significantly associated with the failure group (50.0% vs. 26.7%,
p
= 0.019). The incarceration of an appendicolith (
p
< 0.001, odds ratio = 19.85) and periappendiceal fluid (
p
= 0.009, odds ratio = 3.62) were found to be independent risk factors for failure of NOM. Neither the presence of an appendicolith nor abscess was associated with the recurrence of appendicitis.
Conclusions
The presence of an appendicolith or abscess was not a crucial factor for surgery. Incarceration of an appendicolith and periappendiceal fluid on CT images was predictive factors for the failure of NOM.</description><identifier>ISSN: 1070-3004</identifier><identifier>EISSN: 1438-1435</identifier><identifier>DOI: 10.1007/s10140-021-01951-0</identifier><language>eng</language><publisher>Cham: Springer International Publishing</publisher><subject>Abscesses ; Appendicitis ; Computed tomography ; Emergency Medicine ; Failure ; Imaging ; Imprisonment ; Medical imaging ; Medicine ; Medicine & Public Health ; Original Article ; Radiology ; Risk analysis ; Surgery</subject><ispartof>Emergency radiology, 2021-10, Vol.28 (5), p.977-983</ispartof><rights>American Society of Emergency Radiology 2021</rights><rights>American Society of Emergency Radiology 2021.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c352t-3822f493e2f65c7fecd38ef6e12660987f18c830fb725a3230beea115b82234a3</citedby><cites>FETCH-LOGICAL-c352t-3822f493e2f65c7fecd38ef6e12660987f18c830fb725a3230beea115b82234a3</cites><orcidid>0000-0001-8949-2950</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,777,781,27905,27906</link.rule.ids></links><search><creatorcontrib>Kohga, Atsushi</creatorcontrib><creatorcontrib>Kawabe, Akihiro</creatorcontrib><creatorcontrib>Yajima, Kiyoshige</creatorcontrib><creatorcontrib>Okumura, Takuya</creatorcontrib><creatorcontrib>Yamashita, Kimihiro</creatorcontrib><creatorcontrib>Isogaki, Jun</creatorcontrib><creatorcontrib>Suzuki, Kenji</creatorcontrib><creatorcontrib>Muramatsu, Katsuaki</creatorcontrib><title>Does the presence of an appendicolith or abscess predict failure of nonoperative management of patients with acute appendicitis?</title><title>Emergency radiology</title><addtitle>Emerg Radiol</addtitle><description>Purpose
Nonoperative management (NOM) has been widely accepted as one of the standard treatments for patients with acute appendicitis. However, predictive factors for the failure of NOM have not been thoroughly investigated.
Methods
A total of 196 patients with acute appendicitis underwent NOM between April 2014 and December 2020. Of these 196 patients, 24 patients failed NOM and required emergency surgery (failure group:
n
= 24), while the other 172 patients were successfully treated with NOM (success group:
n
= 172). These two groups were compared, and the predictive factors for the failure of NOM were investigated.
Results
The number of patients who had a previous history of stroke was significantly increased in the failure group (12.5% vs. 2.9%,
p
= 0.026). Incarceration of an appendicolith on CT images was significantly associated with the failure group (20.8% vs. 1.7%,
p
< 0.001), while neither the presence of an appendicolith nor abscess was associated. The presence of periappendiceal fluid was significantly associated with the failure group (50.0% vs. 26.7%,
p
= 0.019). The incarceration of an appendicolith (
p
< 0.001, odds ratio = 19.85) and periappendiceal fluid (
p
= 0.009, odds ratio = 3.62) were found to be independent risk factors for failure of NOM. Neither the presence of an appendicolith nor abscess was associated with the recurrence of appendicitis.
Conclusions
The presence of an appendicolith or abscess was not a crucial factor for surgery. Incarceration of an appendicolith and periappendiceal fluid on CT images was predictive factors for the failure of NOM.</description><subject>Abscesses</subject><subject>Appendicitis</subject><subject>Computed tomography</subject><subject>Emergency Medicine</subject><subject>Failure</subject><subject>Imaging</subject><subject>Imprisonment</subject><subject>Medical imaging</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Original Article</subject><subject>Radiology</subject><subject>Risk analysis</subject><subject>Surgery</subject><issn>1070-3004</issn><issn>1438-1435</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNp9kU1LxDAQhoso-PkHPAW8eKlOkqZpTyJ-g-BFzyGbnayVblKTVPHmTzfdFQUPXmaGmed9SXiL4pDCCQWQp5ECraAERkugrch1o9ihFW_KXMRmnkFCyQGq7WI3xhcAqNu62Sk-Lz1Gkp6RDAEjOoPEW6Id0cOAbt4Z33fpmfhA9CwajHHi8joRq7t-DCvceecHDDp1b0iW2ukFLtGl6TTkZR4jeZ9stBkT_lh3qYtn-8WW1X3Eg---VzxdXz1e3Jb3Dzd3F-f3peGCpZI3jNmq5chsLYy0aOa8QVsjZXUNbSMtbUzDwc4kE5ozDjNETamYZSGvNN8rjte-Q_CvI8akll3-UN9rh36MiolKiFbWrM3o0R_0xY_B5ddlSjLJWioniq0pE3yMAa0aQrfU4UNRUFMoah2KyqGoVSgKsoivRTHDboHh1_of1RfwdJB-</recordid><startdate>20211001</startdate><enddate>20211001</enddate><creator>Kohga, Atsushi</creator><creator>Kawabe, Akihiro</creator><creator>Yajima, Kiyoshige</creator><creator>Okumura, Takuya</creator><creator>Yamashita, Kimihiro</creator><creator>Isogaki, Jun</creator><creator>Suzuki, Kenji</creator><creator>Muramatsu, Katsuaki</creator><general>Springer International Publishing</general><general>Springer Nature B.V</general><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FE</scope><scope>8FG</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>M0S</scope><scope>M1P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-8949-2950</orcidid></search><sort><creationdate>20211001</creationdate><title>Does the presence of an appendicolith or abscess predict failure of nonoperative management of patients with acute appendicitis?</title><author>Kohga, Atsushi ; Kawabe, Akihiro ; Yajima, Kiyoshige ; Okumura, Takuya ; Yamashita, Kimihiro ; Isogaki, Jun ; Suzuki, Kenji ; Muramatsu, Katsuaki</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c352t-3822f493e2f65c7fecd38ef6e12660987f18c830fb725a3230beea115b82234a3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Abscesses</topic><topic>Appendicitis</topic><topic>Computed tomography</topic><topic>Emergency Medicine</topic><topic>Failure</topic><topic>Imaging</topic><topic>Imprisonment</topic><topic>Medical imaging</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Original Article</topic><topic>Radiology</topic><topic>Risk analysis</topic><topic>Surgery</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Kohga, Atsushi</creatorcontrib><creatorcontrib>Kawabe, Akihiro</creatorcontrib><creatorcontrib>Yajima, Kiyoshige</creatorcontrib><creatorcontrib>Okumura, Takuya</creatorcontrib><creatorcontrib>Yamashita, Kimihiro</creatorcontrib><creatorcontrib>Isogaki, Jun</creatorcontrib><creatorcontrib>Suzuki, Kenji</creatorcontrib><creatorcontrib>Muramatsu, Katsuaki</creatorcontrib><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Emergency radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kohga, Atsushi</au><au>Kawabe, Akihiro</au><au>Yajima, Kiyoshige</au><au>Okumura, Takuya</au><au>Yamashita, Kimihiro</au><au>Isogaki, Jun</au><au>Suzuki, Kenji</au><au>Muramatsu, Katsuaki</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Does the presence of an appendicolith or abscess predict failure of nonoperative management of patients with acute appendicitis?</atitle><jtitle>Emergency radiology</jtitle><stitle>Emerg Radiol</stitle><date>2021-10-01</date><risdate>2021</risdate><volume>28</volume><issue>5</issue><spage>977</spage><epage>983</epage><pages>977-983</pages><issn>1070-3004</issn><eissn>1438-1435</eissn><abstract>Purpose
Nonoperative management (NOM) has been widely accepted as one of the standard treatments for patients with acute appendicitis. However, predictive factors for the failure of NOM have not been thoroughly investigated.
Methods
A total of 196 patients with acute appendicitis underwent NOM between April 2014 and December 2020. Of these 196 patients, 24 patients failed NOM and required emergency surgery (failure group:
n
= 24), while the other 172 patients were successfully treated with NOM (success group:
n
= 172). These two groups were compared, and the predictive factors for the failure of NOM were investigated.
Results
The number of patients who had a previous history of stroke was significantly increased in the failure group (12.5% vs. 2.9%,
p
= 0.026). Incarceration of an appendicolith on CT images was significantly associated with the failure group (20.8% vs. 1.7%,
p
< 0.001), while neither the presence of an appendicolith nor abscess was associated. The presence of periappendiceal fluid was significantly associated with the failure group (50.0% vs. 26.7%,
p
= 0.019). The incarceration of an appendicolith (
p
< 0.001, odds ratio = 19.85) and periappendiceal fluid (
p
= 0.009, odds ratio = 3.62) were found to be independent risk factors for failure of NOM. Neither the presence of an appendicolith nor abscess was associated with the recurrence of appendicitis.
Conclusions
The presence of an appendicolith or abscess was not a crucial factor for surgery. Incarceration of an appendicolith and periappendiceal fluid on CT images was predictive factors for the failure of NOM.</abstract><cop>Cham</cop><pub>Springer International Publishing</pub><doi>10.1007/s10140-021-01951-0</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-8949-2950</orcidid></addata></record> |
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source | Springer Nature |
subjects | Abscesses Appendicitis Computed tomography Emergency Medicine Failure Imaging Imprisonment Medical imaging Medicine Medicine & Public Health Original Article Radiology Risk analysis Surgery |
title | Does the presence of an appendicolith or abscess predict failure of nonoperative management of patients with acute appendicitis? |
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