B.-F. Sheu MD; T.-F. Chiu MD; J.-C. Chen MD; M.-S. Tung MD; M.-W. Chang MD; Y.-R. Young MD.
RISK FACTORS ASSOCIATED WITH PERFORATED APPENDICITIS IN ELDERLY PATIENTS PRESENTING WITH SIGNS AND SYMPTOMS OF ACUTE APPENDICITIS
Article first published online: 17 JUL 2007
ANZ Journal of Surgery
Volume 77, Issue 8, pages 662–666, August 2007
How to Cite
Sheu, B.-F., Chiu, T.-F., Chen, J.-C., Tung, M.-S., Chang, M.-W. and Young, Y.-R. (2007), RISK FACTORS ASSOCIATED WITH PERFORATED APPENDICITIS IN ELDERLY PATIENTS PRESENTING WITH SIGNS AND SYMPTOMS OF ACUTE APPENDICITIS. ANZ Journal of Surgery, 77: 662–666. doi: 10.1111/j.1445-2197.2007.04182.x
- Issue published online: 17 JUL 2007
- Article first published online: 17 JUL 2007
- Accepted for publication 25 January 2007.
Background: The aim of this study was to identify factors associated with rupture in elderly patients with acute appendicitis.
Methods: The medical records of 601 consecutive patients >60 years of age with acute appendicitis between 1995 and 2005 were retrospectively reviewed. Historical, clinical and laboratory factors in patients with both intact and ruptured appendices were examined with univariate and multivariate analyses by logistic regressions.
Results: Nine factors predicted appendiceal rupture age (odds ratio (OR) 1.05, confidence interval (CI) 1.02–1.07), male sex (OR 1.96, CI 1.35–2.06), preadmission duration of pain (OR 1.23, CI 1.11–1.36), interval of time from admission to surgery (OR 1.02, CI 1.01–1.04), fever >38°C (OR 2.59, CI 1.78–3.77), left shift in leucocyte count >76% (OR 2.34, CI 1.27–4.32), anorexia (OR 2.03, CI 1.38–2.99) and a retrocaecally positioned appendix (OR 1.93, CI 1.15–3.24).
Conclusion: The incidence of appendiceal rupture, or complications secondary to appendiceal rupture, in elderly patients may be decreased if surgery is expedited when the temperature is >38°C or there is a left shift in leucocyte count >76%, especially in men with anorexia.