The comparative study of predictive factors for prolonged length of stays that adult patients with acute appendicitis in emergency department.
- Author:
Young Jae JANG
1
;
Sin Young KIM
;
Dae Young HONG
;
Kwang Je BAEK
;
Sang O PARK
;
Jong Won KIM
;
Jin Yong KIM
;
Kyeong Ryong LEE
Author Information
1. Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea. lkrer@kuh.ac.kr
- Publication Type:Comparative Study ; Original Article
- Keywords:
Appendicitis;
Length of stay;
Hospitalization;
Diagnosis-related groups
- MeSH:
Adult*;
Appendicitis*;
Appendix;
Body Temperature;
C-Reactive Protein;
Clinical Study;
Diagnosis-Related Groups;
Emergencies*;
Emergency Service, Hospital*;
Fever;
Hospitalization;
Humans;
Length of Stay;
Leukocyte Count;
Logistic Models;
Male;
Medical Records;
Physical Examination;
Retrospective Studies;
Vital Signs
- From:Journal of the Korean Society of Emergency Medicine
2018;29(6):671-678
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
OBJECTIVE: This study examined the predictive factors for prolonged length of stays of adult patients with acute appendicitis (AA) in an emergency department (ED). METHODS: This was a retrospectively clinical study including patients in an ED. All patients were diagnosed from the clinical symptoms and a typical physical examination, and had undergone a computed tomography (CT) evaluation on the ED visiting date. All data were collected from the electrical medical records. The clinical parameters analyzed were the laboratory data, including the white blood cell count with differential values, C-reactive protein (CRP) level, initial vital signs, duration of admission, coexisting perforation of the appendix in the CT findings. The relationship between the clinical parameters and length of stay was assessed. RESULTS: A total of 547 patients with AA were enrolled in this study. Among them, there were 270 male patients with a mean age of 40.7±15.8 years. The baseline characteristics, initial clinical features, laboratory, and imaging studies results of 129 patients in the prolonged length of stay (pLOS) group, and 418 patients of the non-pLOS group in AA were compared. Multivariable logistic regression analysis revealed the predictive factors related to pLOS in AA to be as follows: age 40 years or older, body temperature over 37.3℃, CRP level greater than 5.0 mg/dL, and evidence of perforation in CT findings (P < 0.001). CONCLUSION: If we check age, fever, CRP level and find evidence of perforation, it might be helpful for predicting the increasing period of length of hospital stay for patients with AA in ED.
