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Risk Factors to Predict Post-Operative Organ/Space Infection After Appendectomy in the Pediatric Population: A
Yutong Zhong1,2,3, Bingshan Xia1,3, Qianyang Liu1,3
1Department of Pediatrics, Women's and Children's Hospital, Chongqing Medical University, Chongqing, P.R. China.
Insights
Post-operative organ/space infection (OSI) in children after appendectomy is predicted by complicated appendicitis, low lymphocyte-C-reactive protein, pan-peritonitis, SIRS, and abscesses. Identifying these risk factors can help in choosing more appropriate treatment strategies.
Area of Science:
- Pediatric Surgery
- Infectious Diseases
- Surgical Outcomes
Background:
- Post-operative organ/space infection (OSI) following appendectomy in pediatric patients can lead to extended hospital stays and readmissions.
- Identifying predictors for OSI is crucial for improving patient outcomes and optimizing treatment strategies.
Purpose of the Study:
- To investigate the risk factors associated with organ/space infection (OSI) in pediatric patients who have undergone appendectomy.
- To identify key predictors that can aid in the early detection and management of OSI.
Main Methods:
- A multicenter case-control study was conducted involving pediatric patients with appendicitis who underwent appendectomy between January 2009 and December 2019.
- Multivariable logistic regression analysis was employed to identify potential risk factors for OSI.
- Receiver operating characteristic (ROC) curve analysis was used to evaluate the predictive accuracy of identified factors.
Main Results:
- The study identified several significant predictors for OSI, including complicated appendicitis (OR, 1.82), low pre-operative lymphocyte-C-reactive protein (LCR) (OR, 14.42), pan-peritonitis (OR, 4.36), systemic inflammatory response syndrome (SIRS) (OR, 8.22), and abscess presentation (OR, 11.32).
- The identified factors demonstrated relatively high accuracy in predicting OSI, as confirmed by ROC curve evaluation.
- A total of 723 patients met the criteria for OSI in the analyzed cohort.
Conclusions:
- Complicated appendicitis, low LCR, pan-peritonitis, SIRS, and abscesses are significant predictors of post-operative organ/space infection in pediatric appendectomy patients.
- These identified risk factors can be utilized for early OSI identification and to guide more rational treatment planning.
- Further research can focus on developing targeted interventions based on these predictive factors to reduce OSI incidence.
Abstract:
Post-operative organ/space infection (OSI) is associated with prolonged hospital stay or re-admission. Here, we explore the predictors for OSI in pediatric patients after appendectomy. Among post-appendectomy pateints, the OSI was reviewed. A multicenter case control study was conducted to explore the risk factors for OSI among pediatric patients with appendicitis after appendectomy between January 2009 and December 2019. The potential risk factors associated with OSI were explored using multivariable logistic regression methods. In the current cohort, 723 patients fulfilled the OSI criteria. According to multivariable logistic regression analysis, the occurrence of OSI was associated with complicated appendicitis (odds ratio [OR], 1.82; 95% confidence interval [CI], 1.03-3.686; p = 0.016), the lower the level of pre-operative lymphocyte-C-reactive protein (LCR; OR, 14.42; 95% CI, 1.57-73.26; p < 0.001), pan-peritonitis (OR, 4.36; 95% CI, 1.34-21.66; p = 0.006), systemic inflammatory response syndrome (SIRS; OR, 8.22; 95% CI, 1.84-49.63; p < 0.001), and abscess presentation (OR, 11.32; 95% CI, 2.03-61.86; p < 0.001). The receiver operating characteristic (ROC) curve evaluation further confirmed the relatively high accuracy of the above factors to predict OSI. The identified potential risk factors in the current research can be used for OSI identification in patients after appendectomy. Recognition of the risk factors may allow the choice of the treatment process more reasonably.
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