Preoperative predictor of extensive resection for acute appendicitis.

BACKGROUND

Appendectomy has been the preferred treatment of acute appendicitis. However, extensive resection (ER) such as an ileocecal resection is sometimes needed. We analyzed the predictive factors of ER.

METHODS

This was a retrospective study of 927 patients with acute appendicitis in 7 years. The data collected, including demographic characteristics, laboratory tests, computed tomography (CT) findings and days from onset.

RESULTS

ER was performed in 40 patients (4.3%). Age, days from onset, C-reactive protein (CRP), and the presence of several CT findings were significantly higher in the ER group than others (p < 0.01). In a multivariate analysis, four variables (appendiceal mass, non-visualization of appendix, delayed admission, and CRP) retained statistical significance as predictors of ER (p < 0.01).

CONCLUSIONS

We demonstrated that the four factors are clinically useful for predicting preoperatively whether or not ER is required. These may help in management decisions, including surgical procedure and anesthesia.