Skip to main content
Log in

Are there reliable indicators predicting post-operative complications in acute appendicitis?

  • Original Article
  • Published:
Pediatric Surgery International Aims and scope Submit manuscript

Abstract

Purpose

To clarify the predictors of post-operative complications of pediatric acute appendicitis.

Methods

The medical records of 485 patients with acute appendicitis operated on between January 2006 and November 2014 were retrospectively reviewed. Age, sex, preoperative WBC, CRP, and appendix maximum short diameter on diagnostic imaging (AMSD) were compared retrospectively with the complications group (Group C) vs the non-complication group (Group NC) by Student’s T test, Fisher exact test and Multivariate analysis. Regression analysis with p less than 0.01 was considered significant. We analyzed the most recent 314 laparoscopic appendectomy patients similarly.

Results

Complications were found in 29 of the 485 appendectomies (6.0 %). Comparing Group C to Group NC, preoperative WBC (×103/μl) 16.4 ± 5.6 vs 14.1 ± 4.1 (p < 0.01), CRP (mg/dl) 8.3 ± 7.1 vs 3.3 ± 4.6 (p < 0.01), AMSD (mm) was 12.1 ± 3.7 vs 9.9 ± 2.8 (p < 0.01). The CRP was significantly different by Multivariate analysis, but the WBC and AMSD wasn’t. The results following laparoscopic appendicectomy data were identical.

Conclusion

Preoperative WBC, CPR and AMSD all indicated an increased risk of complications. If WBC (/μl) >16,500, CRP >3.1 mg/dl and AMSD >11.4 mm, complications increased sixfold.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

References

  1. Pearl RH, Hale DA, Molloy M et al (1995) Pediatric appendectomy. J Pediatr Surg 30:173–178

    Article  CAS  PubMed  Google Scholar 

  2. Jordan JS, Kovalcik PJ, Schwab CW (1981) Appendicitis with a palpable mass. Ann Surg 193:227–229

    Article  PubMed Central  CAS  PubMed  Google Scholar 

  3. Kokoska ER, Silen ML, Tracy TF Jr et al (1998) Perforated appendicitis in children: risk factors for the development of complications. Surgery 124:619–625

    Article  CAS  PubMed  Google Scholar 

  4. Henry MC, Walker A, Silverman BL et al (2007) Risk factors for the development of abdominal abscess following operation for perforated appendicitis in children: a multicenter case-control study. Arch Surg 142:236–241

    Article  PubMed  Google Scholar 

  5. Birnbaum BA, Wilson SR (2000) Appendicitis at the millennium. Radiology 215:337–348

    Article  CAS  PubMed  Google Scholar 

  6. Newman K, Ponsky T, Kittle K et al (2003) Appendicitis 2000: variability in practice, outcomes, and resource utilization at thirty pediatric hospitals. J Pediatr Surg 38:372–379

    Article  PubMed  Google Scholar 

  7. Shimizu T, Ishizuka M, Kubota K (2014) The preoperative serum C-reactive protein level is a useful predictor of surgical site infections in patients undergoing appendectomy. Surg Today. doi:10.1007/s00595-014-1086-y

    Google Scholar 

  8. Bixby SD, Lucey BC, Soto JA et al (2006) Perforated versus nonperforated acute appendicitis: accuracy of multidetector CT detection. Radiology 241:780–786

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Hiroaki Kitagawa.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Obayashi, J., Ohyama, K., Manabe, S. et al. Are there reliable indicators predicting post-operative complications in acute appendicitis?. Pediatr Surg Int 31, 1189–1193 (2015). https://doi.org/10.1007/s00383-015-3786-9

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00383-015-3786-9

Keywords

Navigation