Predictive factors for recurrent acute appendicitis after conservative treatment

Area of Science:

• Gastroenterology and Hepatology
• Surgical Innovation
• Radiology

Background:

• Conservative treatment for acute appendicitis is increasingly utilized.
• Accurate identification of patients at higher risk for recurrent appendicitis is crucial for treatment planning.
• Previous studies on predictive factors for recurrence in adults have yielded inconsistent results.

Purpose of the Study:

• To identify significant predictive factors for recurrent appendicitis following conservative management.
• To refine patient selection for non-operative treatment of acute appendicitis.

Main Methods:

• Retrospective study of 379 patients treated conservatively for acute appendicitis (2012-2019).
• Data collection included patient demographics, clinical data, and radiologic findings from medical charts.
• Uni- and multivariable logistic regression analyses were performed to identify risk factors.

Main Results:

• A recurrence rate of 20.6% (78/379) was observed, with a median time to recurrence of 6.5 months.
• Significant independent risk factors for recurrence identified via multivariable analysis included external appendix diameter >10 mm (OR 2.4) and intra-abdominal abscess (OR 2.05).
• Appendicolith was not found to be associated with an increased risk of recurrence.

Conclusions:

• Abscess formation and appendix distension greater than 10 mm are significant risk factors for recurrent appendicitis after successful conservative treatment.
• These imaging findings can aid clinicians in predicting recurrence risk and optimizing management strategies for acute appendicitis.