Risk factors associated with perforated appendicitis in elderly patients presenting with signs and symptoms of acute appendicitis.
BACKGROUND
The aim of this study was to identify factors associated with rupture in elderly patients with acute appendicitis.


METHODS
The medical records of 601 consecutive patients >60 years of age with acute appendicitis between 1995 and 2005 were retrospectively reviewed. Historical, clinical and laboratory factors in patients with both intact and ruptured appendices were examined with univariate and multivariate analyses by logistic regressions.


RESULTS
Nine factors predicted appendiceal rupture age (odds ratio (OR) 1.05, confidence interval (CI) 1.02-1.07), male sex (OR 1.96, CI 1.35-2.06), preadmission duration of pain (OR 1.23, CI 1.11-1.36), interval of time from admission to surgery (OR 1.02, CI 1.01-1.04), fever >38 degrees C (OR 2.59, CI 1.78-3.77), left shift in leucocyte count >76% (OR 2.34, CI 1.27-4.32), anorexia (OR 2.03, CI 1.38-2.99) and a retrocaecally positioned appendix (OR 1.93, CI 1.15-3.24).


CONCLUSIONS
The incidence of appendiceal rupture, or complications secondary to appendiceal rupture, in elderly patients may be decreased if surgery is expedited when the temperature is >38 degrees C or there is a left shift in leucocyte count >76%, especially in men with anorexia.
Sheu
Bor-Fuh
BF
Department of Emergency Medicine, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Chiu
Te-Fa
TF
Chen
Jih-Chang
JC
Tung
Meng-Sheng
MS
Chang
Meng-Wei
MW
Young
Yui-Rwei
YR
D000208:Acute Disease; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000150:complications* / Q000209:etiology*; D005260:Female; D005334:Fever; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors