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    Influence of delays on perforation risk in adults with acute appendicitis.

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    Authors
    Kearney, D
    Cahill, R A
    O'Brien, E
    Kirwan, W O
    Redmond, H P
    Affiliation
    Department of Surgery, Cork University Hospital, Cork, Ireland.
    Issue Date
    2012-02-03T15:08:18Z
    MeSH
    Adult
    Appendectomy
    Appendicitis/*diagnosis/etiology/*surgery
    Cohort Studies
    Emergency Service, Hospital
    Female
    Humans
    Length of Stay
    Linear Models
    Male
    Middle Aged
    Retrospective Studies
    Risk Factors
    Time Factors
    Triage
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    Citation
    Dis Colon Rectum. 2008 Dec;51(12):1823-7. Epub 2008 Jun 27.
    Journal
    Diseases of the colon and rectum
    URI
    http://hdl.handle.net/10147/208951
    DOI
    10.1007/s10350-008-9373-6
    PubMed ID
    18584252
    Abstract
    PURPOSE: This study analyzed whether prehospital or in-hospital delay was the more significant influence on perforation rates for acute appendicitis and whether any clinical feature designated patients requiring higher surgical priority. METHODS: A retrospective analysis was conducted over one year at a tertiary referral hospital without a dedicated emergency surgical theater. Admission notes, theater logbook, and the Hospital Inpatient Enquiry system were reviewed to identify the characteristics and clinical course of patients aged greater than 16 years who were operated upon for histologically confirmed acute appendicitis. RESULTS: One hundred and fifteen patients were studied. The overall perforation rate was 17 percent. The mean duration of symptoms prior to hospital presentation was 38.1 hours with the mean in-hospital waiting time prior to operation being 23.4 hours. Although body temperature on presentation was significantly greater in patients found to have perforated appendicitis (P < 0.05), only patient heart rate at presentation and overall duration of symptoms, but not in-hospital waiting time, independently predicted perforation by stepwise linear regression modeling. CONCLUSION: In-hospital delay was not an independent predictor of perforation in adults with acute appendicitis although delays may contribute if patients are left to wait unduly. Tachycardia at presentation may be a quantifiable feature of those more likely to have perforation and who should be given higher surgical priority.
    Language
    eng
    ISSN
    1530-0358 (Electronic)
    0012-3706 (Linking)
    ae974a485f413a2113503eed53cd6c53
    10.1007/s10350-008-9373-6
    Scopus Count
    Collections
    Cork University Hospital

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