title: Predictive Factors to Distinguish Between Patients With Noncomplicated Appendicitis and Those With Complicated Appendicitis.
abstract: OBJECTIVE
  Recently, randomized controlled trials have reported that conservative therapy can be a treatment option in patients with noncomplicated appendicitis. However, preoperative diagnosis of noncomplicated appendicitis is difficult. In this study, we determined predictive factors to distinguish patients with noncomplicated appendicitis from those with complicated appendicitis.
  
  
  METHODS
  A total of 351 patients who underwent surgical treatment for acute appendicitis from January 2011 to December 2012 were included in this study. We classified patients into noncomplicated or complicated appendicitis groups based on the findings of abdominal computed tomography and pathology. We performed a retrospective analysis to find factors that could be used to discriminate between noncomplicated and complicated appendicitis.
  
  
  RESULTS
  The mean age of the patients in the complicated appendicitis group (54.5 years) was higher than that of the patients in the noncomplicated appendicitis group (40.2 years) (P < 0.001), but the male-to-female ratios were similar. In the univariate analysis, the appendicocecal junction's diameter, appendiceal maximal diameter, appendiceal wall enhancement, periappendiceal fat infiltration, ascites, abscesses, neutrophil proportion, C-reactive protein (CRP), aspartate aminotransferase, and total bilirubin were statistically significant factors. However, in the multivariate analysis, the appendiceal maximal diameter (P = 0.018; odds ratio [OR], 1.129), periappendiceal fat infiltration (P = 0.025; OR, 5.778), ascites (P = 0.038; OR, 2.902), and CRP (P < 0.001; OR, 1.368) were statistically significant.
  
  
  CONCLUSIONS
  Several factors can be used to distinguish between noncomplicated and complicated appendicitis. Using these factors, we could more accurately distinguish patients with noncomplicated appendicitis from those with complicated appendicitis.
authors.affiliation: Department of Surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Tae Hyung
authors.initials: TH
authors.lastname: Kim
authors.affiliation: Department of Surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Byung Sun
authors.initials: BS
authors.lastname: Cho
authors.affiliation: Department of Surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Jae Hag
authors.initials: JH
authors.lastname: Jung
authors.affiliation: Department of Surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Moon Soo
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Department of Surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Je Ho
authors.initials: JH
authors.lastname: Jang
authors.affiliation: Department of Surgery, Eulji University Hospital, Eulji University School of Medicine, Daejeon, Korea.
authors.forename: Chang Nam
authors.initials: CN
authors.lastname: Kim
keywords: Appendectomy; Appendicitis