1. In this retrospective study, patients who initially presented with acute appendicitis with appendicolithiasis were found to be more likely to have hospital stay, age 65 years or older or 18 to 25 years, hypertension at presentation, elevated body mass index, and hyponatremia. were all found to be predictive of nosocomial appendicitis. pierced.
Evidence evaluation level: 2 (good)
Among the most common surgical conditions, appendicitis is a condition that can cause perforation if left untreated. Some patients with appendicitis also have appendicolithiasis (calcified deposits within the appendix), increasing the risk of complicated appendicitis and perforation. In the present retrospective study, we analyzed data from patients diagnosed with non-perforating acute appendicitis who also presented with appendicoliths. Researchers analyzed medical records, clinical data, and imaging findings to identify factors that can predict the risk of appendix perforation during the course of the disease. Results also showed that more than 16% of patients progressed to in-hospital appendiceal perforation, and that the length of hospital stay was more than twice as long for patients with perforated appendicitis (3.0 days vs. 1.2 days, p <0.001). Patients aged 65 years or older or between 18 and 25 years (OR 4.12; 95% CI: 1.36 to 12.48), hypertension (OR: 3.08; 95% CI: 1.01 to 8.56), and increased BMI of more than 30 kg/m factor2 (OR: 2.78; 95% CI: 1.22-6.04), and hyponatremia (OR: 2.95; 95% CI: 1.19-6.90) were significant predictors of in-hospital appendiceal perforation. Histopathological analysis revealed that signs of severe acute inflammation and/or microabscesses and epithelial damage were significantly more common in patients with appendicoliths compared to those without (p < 0.05 ). In contrast to previous studies, time to appendectomy in this study did not significantly contribute to the risk of perforation, and other laboratory markers, including leukocytosis at presentation, were associated with an increased risk of in-hospital perforation. I hadn't. A limitation of the retrospective nature of this study is the inability to quantify the importance of other laboratory markers such as C-reactive protein levels and hyperbilirubinemia as predictors of appendiceal perforation. However, the use of histopathological analysis can help identify perforations that are not detected by CT due to limited sensitivity, and this investigates factors associated with in-hospital perforation progression in appendiceal stone patients. This is the first study to The results of this study provide insight into the relative risk of appendiceal perforation during hospitalization with and without appendicolithiasis.
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