Hartford Hospital/University of Connecticut, Division of Emergency Medicine, Hartford, Connecticut.
West J Emerg Med. 2012 Dec;13(6):468-71. doi: 10.5811/westjem.2011.6.6679.
A family history of appendicitis has been reported to increase the likelihood of the diagnosis in children and in a retrospective study of adults. We compare positive family history with the diagnosis of acute appendicitis in a prospective sample of adults.
We conducted a prospective observational study of a convenience sample of 428 patients. We compared patients with surgically proven appendicitis to a group without appendicitis. The latter were further grouped by their presenting symptoms: those presenting with a chief complaint of abdominal pain and those with other chief complaints. Participants answered questions regarding their family history of appendicitis. Family history was then compared for the appendicitis group versus the nonappendicitis group as a whole, and then versus the subgroup of patients without appendicitis but with abdominal pain. The primary analysis was a χ(2) test of proportions and the calculation of odds ratio (OR) for the relationship between final diagnosis of appendicitis and family history.
Of 428 patients enrolled, 116 had appendicitis. Of those with other diagnoses, 158 had abdominal pain and 154 had other complaints. Of all patients with appendicitis, 37.9% (confidence interval [Cl] = 29.1-46.8) had positive family history. Of those without appendicitis, 23.7% (Cl = 19.0-28.4) had positive family history. In the subgroup without appendicitis but with abdominal pain, 25.9% (Cl = 19.1-32.8) had positive family history. Both comparisons were significant (P = 0.003; OR = 1.97; 95% Cl = 1.2-3.1; and P=0.034; OR = 1.74; 95% Cl = 1.04-2.9, respectively). By multivariate logistic regression analysis across the full sample, family history was a significant independent predictor (P = 0.011; OR = 1.883) of appendicitis.
Adults presenting to the emergency department with a known family history of appendicitis are more likely to have this disease than those without.
已有研究报道，阑尾炎家族史可增加儿童和成年人阑尾炎诊断的可能性。我们比较了阳性家族史与前瞻性成年人急性阑尾炎患者的诊断。
我们对 428 例便利样本进行了前瞻性观察性研究。我们将手术证实的阑尾炎患者与无阑尾炎患者进行了比较。后者根据主要症状进一步分组：有腹痛主诉的患者和有其他主诉的患者。参与者回答了有关其阑尾炎家族史的问题。然后将家族史与阑尾炎组与非阑尾炎组整体进行比较，然后与无阑尾炎但有腹痛的亚组进行比较。主要分析为比例的 χ(2)检验和计算阑尾炎最终诊断与家族史之间关系的比值比 (OR)。
在纳入的 428 例患者中，有 116 例患有阑尾炎。在其他诊断的患者中，有 158 例有腹痛，有 154 例有其他主诉。在所有患有阑尾炎的患者中，有 37.9%（置信区间 [Cl] = 29.1-46.8）有阳性家族史。在没有阑尾炎的患者中，有 23.7%（Cl = 19.0-28.4）有阳性家族史。在没有阑尾炎但有腹痛的亚组中，有 25.9%（Cl = 19.1-32.8）有阳性家族史。这两个比较均有统计学意义（P = 0.003；OR = 1.97；95% Cl = 1.2-3.1；和 P = 0.034；OR = 1.74；95% Cl = 1.04-2.9）。通过对全样本进行多元逻辑回归分析，家族史是阑尾炎的一个显著独立预测因素（P = 0.011；OR = 1.883）。
在急诊科就诊的已知阑尾炎家族史的成年人更有可能患有这种疾病。
