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1Royal Belgian Society for Surgery, Brussels, Belgium
2Department of General and Digestive Surgery, Iris Hospitals South, Brussels, Belgium
3Department of Surgery, Saint Pierre University Hospital, Brussels, Belgium
© 2024 The Korean Society of Coloproctology
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Characteristic | Acute appendicitis | P-value | |
---|---|---|---|
Uncomplicated (n=161) | Complicated (n=107) | ||
Age (yr) | 33.5 (25.3–41.0) | 38.5 (27.0–52.0) | 0.018 |
Sex | 0.016 |
||
Female | 70 (43.5) | 31 (29.0) | |
Male | 91 (56.5) | 76 (71.0) | |
Nationality | 0.250 | ||
European | |||
Belgian | 59 (36.6) | 44 (41.1) | |
Non-Belgian | 42 (26.1) | 35 (32.7) | |
African | 34 (21.1) | 20 (18.7) | |
Middle Eastern | 7 (4.3) | 2 (1.9) | |
Asian | 5 (3.1) | 1 (0.9) | |
American | 9 (5.6) | 1 (0.9) | |
Unknown | 5 (3.1) | 4 (3.7) | |
Charlson Comorbidity Index | 0 (0–0) | 0 (0–1) | 0.017 |
History of abdominal surgery | 26 (16.1) | 14 (13.1) | 0.490 |
History of other surgeries | 18 (11.2) | 10 (9.3) | 0.631 |
Physical examination at admission | |||
Heart rate (bpm) | 87 (76.0–100.5) | 95 (81.0–108.0) | 0.007 |
Tachycardia (>100 bpm) | 48 (29.8) | 46 (43.0) | 0.027 |
Systolic arterial pressure (mmHg) | 125 (118–138) | 130 (118–140) | 0.286 |
Hypotension (<100 mmHg) | 8 (5.0) | 7 (6.5) | 0.583 |
Temperature (°C) | 36.9 (36.5–37.4) | 37.0 (36.7–37.5) | 0.039 |
Fever (>37.8 °C) | 19 (11.8) | 18 (16.8) | 0.243 |
Septic shock | 4 (2.5) | 2 (1.9) | >0.999 |
Blood test at admission | |||
C-reactive protein (g/dL) | 29.2 (6.5–101.0) | 97.5 (29.6–188.3) | <0.001 |
White blood cell count (/mm3) | 13,460 (8,216–16,170) | 15,720 (12,040–18,500) | 0.001 |
Surgical intervention | 0.020 |
||
Appendicectomy | 158 (98.1) | 99 (92.5) | |
Cecectomy | 1 (0.6) | 7 (6.5) | |
Ileocecal resection | 2 (1.2) | 1 (0.9) | |
Laparoscopic procedure | 156 (96.9) | 91 (85.0) | <0.001 |
Drainage | 83 (51.6) | 84 (78.5) | <0.001 |
Periappendicular | 42 (26.1) | 59 (55.1) | <0.001 |
Pelvic | 63 (39.1) | 57 (53.3) | 0.025 |
Other localizations | 6 (3.7) | 4 (3.7) | >0.999 |
Variable | Acute appendicitis | P-value | |
---|---|---|---|
Uncomplicated (n=161) | Complicated (n=107) | ||
Culture | 0.016 |
||
Negative | 75 (46.6) | 34 (31.8) | |
Positive | 86 (53.4) | 73 (68.2) | |
Bacterial isolation | |||
Gram-negative | 76 (47.2) | 65 (60.7) | 0.030 |
Gram-positive | 26 (16.1) | 24 (22.4) | 0.196 |
Strict anaerobes | 18 (11.2) | 22 (20.6) | 0.035 |
First-line antibiotic treatment | 0.013 |
||
None | 7 (4.3) | 2 (1.9) | |
Monotherapy | 154 (95.7) | 100 (93.5) | |
Combined therapy | 0 (0) | 5 (4.7) | |
First-line antibiotic treatment | |||
None | 7 (4.3) | 2 (1.9) | 0.098 |
Amoxicillin/clavulanic acid | 152 (94.4) | 96 (89.7) | |
Amoxicillin/clavulanic acid-metronidazole | 0 (0) | 1 (0.9) | |
Amoxicillin/clavulanic acid-ornidazole | 0 (0) | 1 (0.9) | |
Cefuroxime-metronidazole | 0 (0) | 1 (0.9) | |
Cefuroxime-ornidazole | 0 (0) | 2 (1.9) | |
Clindamycin | 2 (1.2) | 1 (0.9) | |
Levofloxacin | 0 (0) | 1 (0.9) | |
Piperacillin/tazobactam | 0 (0) | 2 (1.9) | |
Resistance to first-line antibiotic treatment | 27 (16.8) | 10 (9.3) | 0.084 |
Second-line antibiotic treatment | 0.889 | ||
None | 132 (80.2) | 86 (80.4) | |
Monotherapy | 11 (6.8) | 9 (8.4) | |
Combined therapy | 18 (11.2) | 12 (11.2) | |
Second-line antibiotic treatment | |||
None | 132 (82.0) | 86 (80.4) | 0.763 |
Amoxicillin/clavulanic acid-metronidazole | 0 (0) | 1 (0.9) | |
Amoxicillin/clavulanic acid-ornidazole | 6 (3.7) | 4 (3.7) | |
Amoxicillin/clavulanic acid-doxycycline | 1 (0.6) | 0 (0) | |
Cefuroxime-metronidazole | 1 (0.6) | 0 (0) | |
Cefuroxime-ornidazole | 1 (0.6) | 0 (0) | |
Ceftriaxone-doxycycline | 2 (1.2) | 0 (0) | |
Doxycycline | 0 (0) | 1 (0.9) | |
Levofloxacin | 3 (1.9) | 2 (1.9) | |
Levofloxacin-ornidazole | 4 (2.5) | 4 (3.7) | |
Ciprofloxacin-ornidazole | 3 (1.9) | 3 (2.8) | |
Piperacillin/tazobactam | 8 (5.0) | 5 (4.7) | |
Ornidazole | 0 (0) | 1 (0.9) | |
Resistance to second-line antibiotic treatment | 0 (0) | 1 (0.9) | 0.399 |
Third-line antibiotic treatment | 0.337 | ||
None | 159 (98.8) | 103 (96.3) | |
Monotherapy | 1 (0.6) | 1 (0.9) | |
Combined therapy | 1 (0.6) | 1 (0.9) | |
Third-line antibiotic treatment | 0.552 | ||
None | 159 (98.8) | 103 (96.3) | |
Levofloxacin-ornidazole | 1 (0.6) | 1 (0.9) | |
Ciprofloxacin-ornidazole | 0 (0) | 1 (0.9) | |
Piperacillin/tazobactam | 1 (0.6) | 1 (0.9) | |
Ceftazidime-vancomycin-ornidazole-anidulafungin | 0 (0) | 1 (0.9) | |
Resistance to third-line antibiotic treatment | 0 (0) | 0 (0) | >0.999 |
Antibiotic treatment duration (day) | 5.0 (2–7) | 5.5 (3–7) | 0.002 |
Antibiotic treatment >1 wk | 19 (11.8) | 22 (20.6) | 0.051 |
Variable | Acute appendicitis | P-value | |
---|---|---|---|
Uncomplicated (n = 161) | Complicated (n = 107) | ||
Morbidity | 11 (6.8) | 21 (19.6) | 0.002 |
Clavien-Dindo classification of 30-day complications | 0.012 |
||
Grade I | 2 (1.2) | 6 (5.6) | |
Grade II | 4 (2.5) | 9 (8.4) | |
Grade III | 5 (3.1) | 6 (5.6) | |
Reintervention | 3 (1.9) | 4 (3.7) | 0.442 |
Specific complication | |||
Postoperative ileus | 4 (2.5) | 6 (5.6) | 0.204 |
Acute kidney injury | 0 (0) | 1 (0.9) | 0.399 |
Bacteremia | 0 (0) | 1 (0.9) | 0.399 |
Surgical site infection | 8 (5.0) | 14 (13.1) | 0.018 |
Cecal perforation | 1 (0.6) | 1 (0.9) | >0.999 |
Blood test at 48 hr | |||
C-reactive protein (mg/dL) | 111.9 (28.9–215.7) | 202.4 (96.6–316.0) | 0.001 |
White blood cell count (/mm3) | 8,660 (6,715–10,980) | 8,695 (6,335–12,052) | 0.447 |
Hospital stay (day) | 3 (2–5) | 5 (3–6) | <0.001 |
Risk factor | Univariate analysis | Multivariate analysis | ||
---|---|---|---|---|
OR (95% CI) | P-value | OR (95% CI) | P-value | |
Age (yr) | 1.022 (1.005–1.039) | 0.009 |
1.022 (1.005–1.039) | 0.009 |
Sex | 0.017 |
- | - | |
Female | Reference | |||
Male | 1.887 (1.120–3.174) | |||
Nationality | 0.249 | - | - | |
European (Belgian) | Reference | |||
European (non-Belgian) | 1.117 (0.617–2.025) | |||
African | 0.789 (0.401–1.551) | |||
Middle Eastern | 0.383 (0.076–1.934) | |||
Asian | 0.268 (0.030–2.378) | |||
American | 0.149 (0.018–1.120) | |||
Charlson Comorbidity Index | 1.459 (1.114–1.911) | 0.006 |
1.333 (1.003–1.771) | 0.048 |
History of abdominal surgery | 0.782 (0.782–1.576) | 0.491 | - | - |
History of other surgeries | 0.819 (0.363–1.850) | 0.631 | - | - |
Physical examination at admission | - | - | ||
Heart rate (bpm) | 1.018 (1.004–1.033) | 0.010 |
||
Tachycardia (>100 bpm) | 1.775 (1.066–2.958) | 0.028 |
||
Systolic arterial pressure (mmHg) | 1.005 (0.990–1.019) | 0.54 | ||
Hypotension (<100 mmHg) | 1.339 (0.471–3.807) | 0.584 | ||
Temperature (°C) | 1.383 (0.994–1.924) | 0.054 | ||
Fever (>37.8 °C) | 1.512 (0.753–3.035) | 0.245 | ||
Septic shock | 0.748 (0.135–4.155) | 0.740 | ||
Blood test at admission | ||||
C-reactive protein (g/dL ) | 1.005 (1.002–1.007) | <0.001 |
- | - |
White blood cell count (/mm3) | 1.00008 (1.00003–1.00014) | <0.001 |
1.00007 (1.00001–1.00013) | 0.027 |
Surgical intervention | - | - | ||
Appendicectomy | Reference | |||
Cecectomy | 11.172 (1.354–92.174) | 0.025 |
||
Ileocecal resection | 0.798 (0.071–8.916) | 0.855 | ||
Laparoscopic procedure | 0.182 (0.065–0.514) | 0.001 |
0.218 (0.073–0.648) | 0.006 |
Drainage | 3.432 (1.970–5.980) | <0.001 |
2.571 (1.421–4.653) | 0.002 |
Culture | 0.016 |
- | - | |
Negative | Reference | |||
Positive | 1.872 (1.123–3.122) | |||
Bacterial isolation | - | - | ||
Gram-negative | 1.731 (1.054–2.843) | 0.030 |
||
Gram-positive | 1.501 (0.809–2.787) | 0.198 | ||
Strict anaerobes | 2.056 (1.043–4.052) | 0.037 |
||
First-line antibiotic treatment | 0.870 (0.704–1.075) | 0.197 | - | - |
Resistance to first-line antibiotic treatment | 0.512 (0.237–1.106) | 0.089 | - | - |
Bacterial specific isolation | - | - | ||
Escherichia coli | 1.550 (0.945–2.543) | 0.083 | ||
Klebsiella spp. | 0.854 (0.244–2.993) | 0.806 | ||
Bacteroides spp. | 2.879 (1.163–7.124) | 0.022 |
||
Pseudomonas aeruginosa | 1.741 (0.683–4.439) | 0.246 | ||
Enterococcus spp. | 1.003 (0.276–3.643) | 0.996 | ||
Streptoccocus anginosus group | 2.102 (1.016–4.347) | 0.045 |
Values are presented as median (interquartile range) or number (%). Percentages may not total 100 due to rounding. bpm, beats per minute. P<0.05 (statistically significant).
Values are presented as number (%) or median (interquartile range). Percentages may not total 100 due to rounding. P<0.05 (statistically significant).
Values are presented as number (%) or median (interquartile range). P<0.05 (statistically significant).
OR, odds ratio; CI, confidence interval; bpm, beats per minute. P<0.05 (statistically significant).