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Risk Factors for Complications in Acute Appendicitis among Paediatric Population
1Department of Surgery, Universal College of Medical Sciences, Bhairahawa, Nepal.
Insights
Prolonged pain duration and elevated white blood cell count are key indicators of complicated appendicitis in children. Early detection of these risk factors improves pediatric appendicitis outcomes.
Area of Science:
- Pediatric Surgery
- Gastroenterology
- Emergency Medicine
Background:
- Appendicitis is a frequent cause of acute abdominal pain in children.
- Early diagnosis and appendectomy before perforation lead to favorable outcomes.
- Atypical presentations in young children complicate appendicitis diagnosis.
Purpose of the Study:
- To identify risk factors for complicated appendicitis in the pediatric population.
- To analyze predictors of intraoperative gangrenous or perforated appendicitis.
Main Methods:
- A cross-sectional study of 73 pediatric patients (age ≤18) undergoing appendectomy.
- Review of preoperative, operative, and postoperative data from January 2014 to December 2015.
- Multivariate logistic regression analysis focusing on age, pain duration, and total leukocyte count.
Main Results:
- Patients with pain duration >72 hours had a 14.6-fold increased likelihood of complicated appendicitis.
- Patients with leukocyte count >15000/mm³ showed a 16.38-fold increased risk of complicated appendicitis.
- Patient age was not found to be an independent predictor of complicated appendicitis.
Conclusions:
- Elevated total leukocyte count and prolonged symptom duration are significant markers for complicated appendicitis in children.
- These findings aid in the early identification and management of severe pediatric appendicitis cases.
Introduction:
Appendicitis is one of the most common causes of acute abdomen in children. Patients who are diagnosed early and undergo an appendectomy before perforation have a good outcome. However, it is difficult to diagnose in young children because its clinical manifestations may be atypical. The aim of this study was to determine the risk factors for complications in acute appendicitis in paediatric population.
Methods:
We performed a cross sectional study on children (age ≤18 years) who underwent appendectomy for suspected appendicitis from January 2014 to December 2015. Medical records of patients who met inclusion criteria were reviewed. Preoperative, operative and post-operative data were analyzed. The main outcome measure was intraoperative confirmation of gangrenous or perforated appendicitis. Multivariate logistic regression analysis was performed, and the main predictors of interest were patient's age, duration of pain and total leucocyte count.
Results:
Total 73 paediatric patients (46 males) with mean age 13±3.8 were studied. In multivariate logistic regression analysis, patients having pain duration more than 72 hours and patients with leucocyte count >15000/mm3 were more likely to have complicated appendicitis [(OR:14.6), (95% CI= 2.40 - 89.77), (P= 0.004)] and [(OR=16.38), (95% CI = 1.836-146), (P = 0.012)] respectively. However, the age of the patient is not independently associated with complicated appendicitis.
Conclusions:
Increase in total leucocyte count and duration of the presentation can be a good marker of complicated appendicitis.
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