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Predicting negative appendectomy by using demographic, clinical, and laboratory parameters: a cross-sectional study.
Hassan Ali Mohebbi1, Shaban Mehrvarz, Mohsen Towliat Kashani
1Trauma Research Center, Baqiyatallah Medical Sciences University, Vanak Square, Molla-Sadra Avenue, Box number: 19945/581, Tehran, Iran.
International Journal of Surgery (London, England)
|February 22, 2008
Summary
Younger age, female gender, lower polymorph nuclear cell percentage, and reduced heart rate are key indicators for avoiding negative appendectomies in acute appendicitis diagnosis. These factors aid surgeons in reducing unnecessary surgeries.
Area of Science:
- Surgery
- Diagnostic Medicine
Background:
- Acute appendicitis (AA) is a common surgical emergency.
- Negative appendectomy (NA) rates present a challenge in AA management.
- Reducing NA without increasing patient risk is a primary surgical goal.
Purpose of the Study:
- To evaluate clinical findings for diagnosing acute appendicitis.
- To determine the diagnostic value of symptoms, signs, and lab data in avoiding NA.
- To identify predictors of negative appendectomy in patients with suspected AA.
Main Methods:
- Cross-sectional study of 1197 patients undergoing open appendectomy.
- Comparison of data between confirmed AA and NA groups.
- Statistical analysis using ANOVA, Kappa, odds ratio, and logistic regression.
Main Results:
- The negative appendectomy rate was 18.2%.
- Independent predictors of NA included younger age (<21 years), female gender, lower polymorph nuclear (PMN) cell percentage, and lower heart rate.
- All identified predictors were statistically significant (P<0.001).
Conclusions:
- Female gender, low PMN percentage, and low pulse rate are significant indicators for NA.
- Age below 21 years is also a predictor of NA.
- These findings can enhance diagnostic accuracy to prevent unnecessary surgeries.
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