Determination of surgical priorities in XXXX based on the probability of undetected appendiceal perforation.

@entity1 @entity697 @entity698 @entity260 @entity954
AIM: To identify risk factors of actual appendiceal perforation when computed tomography (CT) scans suggest nonperforated @entity698 and accordingly determine surgical priority. METHODS: We collected database of 1362 @entity1 who underwent an appendectomy for @entity697 between 2006 and 2013. A single radiologist selected 1236 @entity1 whose CT scans were suggestive of nonperforated @entity698 . @entity1 were divided into 2 groups: actual nonperforation group and actual perforation group according to intraoperative and pathologic features. Comparison of the 2 groups were made using binary logistic regression. RESULTS: Of 1236 @entity1 , 90 (7.3%) were found to have actual appendiceal perforation. Four risk factors related with actual appendiceal perforation were identified: body temperature>= 37.6        C (HR=1.912, 95%CI: 1.161-3.149; P=0.011), out-of-hospital symptom duration>= 72 h (HR=2.454, 95%CI: 1.292-4.662; P=0.006), age>= 35 years (HR=3.358, 95%CI: 1.968-5.728; P<0.001), and appendiceal diameter on CT scan>= 8 mm (HR=4.294, 95%CI: 1.034-17.832; P=0.045). Actual appendiceal perforation group showed longer operation time, later initiation of diet, longer use of parenteral narcotics, longer hospital stay, and higher incidence of @entity260 (P<0.05). CONCLUSION: We proposed here new criteria to select @entity1 with adverse clinical outcomes after appendectomy among the @entity1 with radiologically nonperforated @entity698 . @entity954 outcomes could be improved by determining the surgical priority according to our criteria.
