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High admission C-reactive protein level and longer in-hospital delay to surgery are associated with increased risk of complicated appendicitis
- 作者：Henna E. Sammalkorpi ; Ari Lepp?niemi ; Panu Mentula
- 关键词：Appendicitis ; acute ; Appendicitis ; perforated ; Abdomen ; acute ; C ; reactive protein
- 刊名：Langenbeck's Archives of Surgery
- 出版年：2015
- 出版时间：February 2015
- 年：2015
- 卷：400
- 期：2
- 页码：221-228
- 全文大小：717 KB
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- 刊物主题：Medicine & Public Health
General Surgery
Abdominal Surgery
Cardiac Surgery
Thoracic Surgery
Traumatic Surgery
Vascular Surgery
- 出版者：Springer Berlin / Heidelberg
- ISSN：1435-2451
文摘
Purpose Debate on the effect of in-hospital delay on the risk of perforation in appendicitis persists, and the results from previous studies are controversial. The aims of this study were to present the effect of in-hospital delay on the risk of perforation in appendicitis and to assess the utility of C-reactive protein (CRP) measurement in detecting the patients with complicated appendicitis. Methods Prospectively collected data of 389 adult patients who underwent surgery for acute appendicitis were analyzed in order to find the most accurate method for recognizing the pre-hospital perforations. The effect of in-hospital delay on the further risk of perforation in patients with not yet perforated acute appendicitis was then analyzed. Results Out of 389 patients with appendicitis, 91 patients (23.4?%) had complicated appendicitis, 23 with abscess, and 68 with free perforation. Admission CRP level of 99?mg/l or higher was 90.3?% specific for complicated appendicitis. In patients with admission CRP less than 99?mg/l, the incidence of perforation doubled from 9.5 to 18.9?% when the in-hospital delay increased from less than 6?h to more than 12?h. Conclusions Complicated appendicitis can be identified with a high CRP level on admission. Delaying surgery can increase the risk of perforation.
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