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Predictive factors for recurrent acute appendicitis after conservative treatment

Ramadan, Shaima LU orcid ; Olsson, Åsa LU ; Ekberg, Olle LU and Buchwald, Pamela LU (2024) In Scandinavian Journal of Gastroenterology 59(8). p.933-938
Abstract
Abstract
Introduction
Conservative treatment of acute appendicitis is gaining popularity, and identifying patients with a higher risk of recurrence is becoming increasingly important. Previous studies have suggested that older age, male sex, diabetes, appendicolith and abscess formation may be contributing factors, however, results from the adult population are inconsistent.

Aim
This study aims to identify predictive factors for recurrent appendicitis after conservative treatment.

Methods
This retrospective study included patients with conservatively treated acute appendicitis at Skåne University Hospital, Sweden during 2012-2019. Information on patient demographics at index admission and follow-up data... (More)
Abstract
Introduction
Conservative treatment of acute appendicitis is gaining popularity, and identifying patients with a higher risk of recurrence is becoming increasingly important. Previous studies have suggested that older age, male sex, diabetes, appendicolith and abscess formation may be contributing factors, however, results from the adult population are inconsistent.

Aim
This study aims to identify predictive factors for recurrent appendicitis after conservative treatment.

Methods
This retrospective study included patients with conservatively treated acute appendicitis at Skåne University Hospital, Sweden during 2012-2019. Information on patient demographics at index admission and follow-up data were retrieved from medical charts and radiologic images. Uni -and multivariable logistic regression analysis were performed using Stata Statistical Software.

Results
In total, 379 patients with conservatively treated acute appendicitis were identified, of which 78 (20.6%) had recurrence. All patients were followed-up for a minimum of 41 months after the first diagnosis of acute appendicitis unless appendectomy after successful conservative treatment or death occurred during follow-up. The median time to recurrence was 6.5 (1–17.8) months. After multivariable logistic regression analysis, external appendix diameter >10 mm [OR 2.4 (CI 1.37–4.21), p = .002] and intra-abdominal abscess [OR 2.05 (CI 1.18–3.56), p = .011] on computed tomography were significant independent risk factors for recurrent appendicitis. Appendicolith was not associated with an increased risk of recurrence.

Conclusion
This study suggests abscess formation and appendix distension of >10 mm to be potential risk factors for recurrent acute appendicitis after initial successful conservative treatment. (Less)
Please use this url to cite or link to this publication:
author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Scandinavian Journal of Gastroenterology
volume
59
issue
8
pages
933 - 938
publisher
Taylor & Francis
external identifiers
  • pmid:38814018
  • scopus:85194874642
ISSN
0036-5521
DOI
10.1080/00365521.2024.2359438
language
English
LU publication?
yes
id
5c2c4156-1f01-4432-bd24-924c1519564d
date added to LUP
2024-05-30 16:24:42
date last changed
2024-10-14 11:58:04
@article{5c2c4156-1f01-4432-bd24-924c1519564d,
  abstract     = {{Abstract<br/>Introduction<br/>Conservative treatment of acute appendicitis is gaining popularity, and identifying patients with a higher risk of recurrence is becoming increasingly important. Previous studies have suggested that older age, male sex, diabetes, appendicolith and abscess formation may be contributing factors, however, results from the adult population are inconsistent.<br/><br/>Aim<br/>This study aims to identify predictive factors for recurrent appendicitis after conservative treatment.<br/><br/>Methods<br/>This retrospective study included patients with conservatively treated acute appendicitis at Skåne University Hospital, Sweden during 2012-2019. Information on patient demographics at index admission and follow-up data were retrieved from medical charts and radiologic images. Uni -and multivariable logistic regression analysis were performed using Stata Statistical Software.<br/><br/>Results<br/>In total, 379 patients with conservatively treated acute appendicitis were identified, of which 78 (20.6%) had recurrence. All patients were followed-up for a minimum of 41 months after the first diagnosis of acute appendicitis unless appendectomy after successful conservative treatment or death occurred during follow-up. The median time to recurrence was 6.5 (1–17.8) months. After multivariable logistic regression analysis, external appendix diameter &gt;10 mm [OR 2.4 (CI 1.37–4.21), p = .002] and intra-abdominal abscess [OR 2.05 (CI 1.18–3.56), p = .011] on computed tomography were significant independent risk factors for recurrent appendicitis. Appendicolith was not associated with an increased risk of recurrence.<br/><br/>Conclusion<br/>This study suggests abscess formation and appendix distension of &gt;10 mm to be potential risk factors for recurrent acute appendicitis after initial successful conservative treatment.}},
  author       = {{Ramadan, Shaima and Olsson, Åsa and Ekberg, Olle and Buchwald, Pamela}},
  issn         = {{0036-5521}},
  language     = {{eng}},
  number       = {{8}},
  pages        = {{933--938}},
  publisher    = {{Taylor & Francis}},
  series       = {{Scandinavian Journal of Gastroenterology}},
  title        = {{Predictive factors for recurrent acute appendicitis after conservative treatment}},
  url          = {{http://dx.doi.org/10.1080/00365521.2024.2359438}},
  doi          = {{10.1080/00365521.2024.2359438}},
  volume       = {{59}},
  year         = {{2024}},
}