Perforation rate after a diagnosis of uncomplicated appendicitis on CT

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http://hdl.handle.net/10138/332427

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Lastunen , K , Leppäniemi , A & Mentula , P 2021 , ' Perforation rate after a diagnosis of uncomplicated appendicitis on CT ' , BJS open , vol. 5 , no. 1 , 034 . https://doi.org/10.1093/bjsopen/zraa034

Title: Perforation rate after a diagnosis of uncomplicated appendicitis on CT
Author: Lastunen, K.; Leppäniemi, A.; Mentula, P.
Contributor organization: II kirurgian klinikka
HUS Abdominal Center
University of Helsinki
Helsinki University Hospital Area
Staff Services
Date: 2021-01
Language: eng
Number of pages: 7
Belongs to series: BJS open
ISSN: 2474-9842
DOI: https://doi.org/10.1093/bjsopen/zraa034
URI: http://hdl.handle.net/10138/332427
Abstract: Background: Appendicectomy is a common emergency operation. The aim of this analysis was to study the effect of preoperative delay on disease progression, and whether a novel scoring system(Atema score) could be useful in predicting complicated appendicitis. Methods: Patients with uncomplicated acute appendicitis on CT and who underwent appendicectomy in 2014-2015 were analysed for patient characteristics, preoperative delay and outcomes. Results: Of 837 patients with uncomplicated appendicitis on CT, 187 (22.3 per cent) were found to have complicated appendicitis at surgery. The median time estimate for perforation was 25.4 h after CT, with an hourly rate of perforation of 2 per cent. Patients with an Atema score of 6 or less and those with no appendicolith on CT and a C-reactive protein level below 51 mg/l were the slowest to develop perforation, reaching a perforation rate of 5 per cent in 7.1 and 7.6 h respectively. Conclusion: A substantial proportion of patients with uncomplicated acute appendicitis on CT have complicated appendicitis at surgery. However, in patients with no risk factors, surgery can be postponed safely for up to 7 h.
Subject: 3126 Surgery, anesthesiology, intensive care, radiology
IN-HOSPITAL DELAY
ANTIBIOTIC-THERAPY
APPENDECTOMY
RISK
SURGERY
ADULTS
TIME
COMPLICATIONS
METAANALYSIS
INCREASES
Peer reviewed: Yes
Rights: cc_by_nc
Usage restriction: openAccess
Self-archived version: publishedVersion


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