title: Risk factors for the development of complicated appendicitis in adults.
abstract: OBJECTIVE
  To investigate the patient's history and physical examination information to find out risk factors associated with complicated appendicitis.
  
  
  METHODS
  Two hundred patients who were admitted with complicated appendicitis (including abscess, phlegmon, and generalized peritonitis) were retrieved from our database. Two hundred patients with non-complicated acute appendicitis were randomly selected from the same period. These two groups were compared in terms of demographic characteristics, past medical history, and presenting symptoms. We made a multivariate analysis model using binary logistic regression and backward stepwise elimination.
  
  
  RESULTS
  Based on multivariate analysis, risk factors for complicated appendicitis included presenting with epigastric pain (OR=3.44), diarrhea (OR=23.4) or malaise (OR=49.7), history of RLQ pain within the past 6 months (OR=4.93), older age (OR=1.04), being married (OR=2.52), lack of anorexia (OR=4.63) and longer interval between onset of symptoms and admission (OR=1.46). Conversely, higher (academic) education was associated with decreased odds for complicated appendicitis (OR=0.26).
  
  
  CONCLUSIONS
  Our findings suggest that a surgeon's clinical assessment is more reliable to make a judgment. "Bedside evaluation" is a useful, cheap, quick and readily available method for identifying those at risk for developing complicated acute appendicitis.
authors.affiliation: Department of Surgery, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Naderan
authors.affiliation: Department of Surgery, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
authors.forename: Amir Eslami Shahr
authors.initials: AE
authors.lastname: Babaki
authors.affiliation: Department of Surgery, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
authors.forename: Saeed
authors.initials: S
authors.lastname: Shoar
authors.affiliation: Department of Surgery, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Mahmoodzadeh
authors.affiliation: Department of Surgery, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
authors.forename: Shirzad
authors.initials: S
authors.lastname: Nasiri
authors.affiliation: Department of Surgery, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran.
authors.forename: Zhamak
authors.initials: Z
authors.lastname: Khorgami
keywords: Acute appendicitis; adults; complicated appendicitis; risk factors