دورية أكاديمية
أعرض في EDS

Comparison of Appendectomy for Perforated Appendicitis With and Without Abscess: A National Surgical Quality Improvement Program Analysis.

التفاصيل البيبلوغرافية
العنوان: Comparison of Appendectomy for Perforated Appendicitis With and Without Abscess: A National Surgical Quality Improvement Program Analysis.
المؤلفون: Hester CA; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas., Pickett M; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas., Abdelfattah KR; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas., Cripps MW; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas., Dultz LA; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas., Dumas RP; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas., Grant JL; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas., Luk S; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas., Minei J; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas., Park C; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas., Shoultz TH; Department of Surgery, Division of General and Acute Care Surgery, Dallas, Texas. Electronic address: thomas.shoultz@utsouthwestern.edu.
المصدر: The Journal of surgical research [J Surg Res] 2020 Jul; Vol. 251, pp. 159-167. Date of Electronic Publication: 2020 Mar 06.
نوع المنشور: Comparative Study; Journal Article
اللغة: English
بيانات الدورية: Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE
أسماء مطبوعة: Publication: New York, NY : Academic Press
Original Publication: Philadelphia [etc.]
مواضيع طبية MeSH: Abdominal Abscess/*surgery , Appendectomy/*statistics & numerical data , Appendicitis/*surgery, Abdominal Abscess/etiology ; Adult ; Appendicitis/complications ; Female ; Humans ; Male ; Middle Aged ; Quality Improvement ; Retrospective Studies
مستخلص: Background: Outcomes of appendectomy stratified by type of complicated appendicitis (CA) features are poorly researched, and the evidence to guide operative versus nonoperative management for CA is lacking. This study aimed to determine laparoscopic-to-open conversion risk, postoperative abscess risk, unplanned readmission risk, and length of hospital stay (LOS) associated with appendectomy in patients with perforated appendicitis without abscess (PA) and perforated appendicitis with abscess (PAWA) compared with a control cohort of nonperforated appendicitis (NPA).
Methods: The 2016-2017 National Surgical Quality Improvement Program Appendectomy-targeted database identified 12,537 (76.1%) patients with NPA, 2142 (13.0%) patients with PA, and 1799 (10.9%) patients with PAWA. Chi-squared analysis and analysis of variance were used to compare categorical and continuous variables. Binary logistic and linear regression models were used to compare risk-adjusted outcomes.
Results: Compared with NPA, PA and PAWA had higher rates of conversion (0.8% versus 4.9% and 6.5%, respectively; P < 0.001), postoperative abscess requiring intervention (0.6% versus 4.8% and 7.0%, respectively; P < 0.001), readmission (2.8% versus 7.7% and 7.6%, respectively; P < 0.001), and longer median LOS (1 day versus 2 days and 2 days, respectively; P < 0.001). PA and PAWA were associated with increased odds of postoperative abscess (odds ratio [OR]: 7.18, 95% confidence interval [CI]: 5.2-9.8 and OR: 9.94, 95% CI: 7.3-13.5, respectively), readmission (OR: 2.70, 95% CI: 2.1-3.3 and OR: 2.66, 95% CI: 2.2-3.3, respectively), and conversion (OR: 5.51, 95% CI: 4.0-7.5 and OR: 7.43, 95% CI: 5.5-10.1, respectively). PA was associated with an increased LOS of 1.7 days and PAWA with 1.9 days of LOS (95% CI: 1.5-1.8 and 1.7-2.1, respectively).
Conclusions: Individual features of CA were independently associated with outcomes. Further research is needed to determine if surgical management is superior to nonoperative management for CA.
(Copyright © 2020 Elsevier Inc. All rights reserved.)
فهرسة مساهمة: Keywords: Appendectomy; Complicated appendicitis; Outcomes; Perforated appendicitis
تواريخ الأحداث: Date Created: 20200311 Date Completed: 20200914 Latest Revision: 20200914
رمز التحديث: 20221213
DOI: 10.1016/j.jss.2019.12.054
PMID: 32151825
قاعدة البيانات: MEDLINE
الوصف
تدمد:1095-8673
DOI:10.1016/j.jss.2019.12.054