A study on risk factors of perforation in acute appendicitis
10.3760/cma.j.issn.1673-4904.2018.12.001
- VernacularTitle:急性阑尾炎穿孔的危险因素研究
- Author:
Heyu LI
1
;
Ju WANG
Author Information
1. 内蒙古自治区人民医院胃肠外科
- Keywords:
Acute appendicitis;
Perforation;
Risk factors
- From:
Chinese Journal of Postgraduates of Medicine
2018;41(12):1057-1060
- CountryChina
- Language:Chinese
-
Abstract:
Objective To identify risk factors of perforation in acute appendicitis. Methods Patients with acute appendicitis who underwent surgical treatment from 2016 January to 2017 December were retrospectively reviewed. According to clinical and pathological records, patients were divided into perforation group (including 150 patients) and non-perforation group (including 157 patients). The progress of disease, duration from occurrence to surgery, preoperative highest temperature and pulse rate, and a series of indicators including WBC, NCP, LCP, HCT, CRP, TP through blood routine or biochemical assays. Logistic regression analysis was adopted to analyze the risk factors of perforation were compared. Results Preoperative highest temperature, pulse rate, WBC, NCP, LCP and CRP in perforation and non-perforation group were (37.98 ± 0.54) ℃ vs. (37.58 ± 0.52) ℃, (94.94 ± 20.74) times/min vs. (87.41 ± 15.35) times/min, (15.25 ± 4.71)×109/L vs. (11.04 ± 4.29)×109/L, (83.06 ± 9.84)% vs. (75.27 ± 13.71)%, (11.76 ± 3.73)% vs. (18.23 ± 5.72)%, (89.35 ± 23.10) mg/L vs. (52.16 ± 18.46) mg/L, respectively. There existed significant differences between the two groups (P＜0.05). Logistic regression analysis showed that WBC ( OR＝1.185, 95% CI 1.090-1.280), CRP( OR＝2.043, 95% CI 1.243-2.843), the preoperative highest temperature ( OR＝2.007, 95% CI 1.114-3.616), and pulse rate ( OR＝1.160, 95% CI 1.124-1.196) were risk factors of perforation in patients with acute appendicitis (P＜0.05). The Hosmer-Lemeshow test proved that the predictive accuracy rate of the Logistic model was up to 79.1%. Conclusions WBC, CRP, the preoperative highest temperature and pulse rate are risk factors, which contributes to predict the risk of perforation in patients with acute appendicitis.
