Risk factors associated with perforated acute appendicitis in geriatric emergency patients
Authors Tantarattanapong S, Arwae N
Received 12 May 2018
Accepted for publication 21 July 2018
Published 4 October 2018 Volume 2018:10 Pages 129—134
Checked for plagiarism Yes
Review by Single-blind
Peer reviewer comments 2
Editor who approved publication: Dr Hans-Christoph Pape
Siriwimon Tantarattanapong, Nuraianee Arwae
Department of Emergency Medicine, Songklanagarind Hospital, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
Objective: The aim of this study was to identify factors associated with perforated acute appendicitis in geriatric patients at the emergency department (ED).
Patients and methods: The medical records of 223 consecutive patients aged >60 years with acute appendicitis between 2006 and 2017 were retrospectively reviewed. Patients were grouped into those with perforated and non-perforated appendicitis. A comparison was made between the two groups in regard to baseline characteristics, clinical presentation, physical examination, time from onset of symptoms to ED arrival, time from ED arrival to operation, postoperative complications, hospital length of stay, and mortality. Significant factors associated with perforated appendicitis were examined using univariate and multivariate analyses by logistic regression.
Results: A total of 78 (35%) patients had perforated appendicitis. Four significant factors associated with perforated appendicitis were as follows: 1) time duration from onset of symptoms to ED arrival >24 hours (OR 2.49, CI 1.33–4.68); 2) heart rate ≥90 beats/minute (OR 1.93, CI 1.04–3.59); 3) respiratory rate ≥20 breaths/minute (OR 2.54, CI 1.33–4.84); and 4) generalized guarding (OR 12.58, CI 1.43–110.85).
Conclusion: Time duration from onset of symptoms to ED arrival >24 hours, heart rate ≥90 beats/minute, respiratory rate ≥20 breaths/minute, and generalized guarding were the significant factors associated with perforated acute appendicitis in geriatric patients.
Keywords: perforated appendicitis, geriatric, emergency department.
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