title: C-reactive Protein may Predict the Recurrence of Appendicitis in Children Formerly with Appendiceal Mass after Successful Non-operative Treatment.
abstract: This study identified factors associated with the recurrence of appendicitis in children with appendiceal masses after successful nonsurgical treatment.
  
  
  
  In this retrospective study, children who were diagnosed as having appendiceal masses after undergoing conservative treatment between 2000 and 2014 were enrolled and the medical records of those who did not undergo an interval appendectomy were reviewed. The clinical features and outcomes of patients with and those without recurrent appendicitis were compared. Regression analysis was used to identify risk factors of appendicitis recurrence.
  
  
  
  Seventy patients were included and successfully discharged after receiving nonsurgical treatment for appendiceal masses. Of the patients, 35 (50.0%) developed recurrent appendicitis and 85.7% (30/35) recurrences developed within 3 months. Multivariate analyses showed that patients with a higher serum C-reactive protein (CRP) level and peritonitis more frequently developed recurrence. The appendicitis recurrence rate was significantly higher in the patients with CRP levels of ≥103 mg/L with an odds ratio of 16.9 or in those with peritonitis with an odds ratio of 4.9.
  
  
  
  Children with appendiceal masses who develop peritonitis or have CRP levels of ≥103 mg/L have a higher recurrence rate of appendicitis and should undergo an interval appendectomy.
authors.affiliation: Division of Pediatric General Medicine, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan; Chang Gung University College of Medicine, Taoyuan, Taiwan.
authors.forename: Yi-Jung
authors.initials: YJ
authors.lastname: Chang
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan.
authors.forename: Hsun-Chin
authors.initials: HC
authors.lastname: Chao
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
authors.forename: Chyi-Liang
authors.initials: CL
authors.lastname: Chen
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Division of Pediatric Gastroenterology, Department of Pediatrics, Chang Gung Children's Hospital, Taoyuan, Taiwan.
authors.forename: Shin-Yann
authors.initials: SY
authors.lastname: Chen
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Department of Pediatrics, Chang Gung Memorial Hospital, Taipei Branch, Taipei, Taiwan. Electronic address: yandchome@gmail.com.
authors.forename: Dah-Chin
authors.initials: DC
authors.lastname: Yan
authors.affiliation: Chang Gung University College of Medicine, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Department of Pediatrics, Chang Gung Memorial Hospital, Keelung Branch, Keelung, Taiwan. Electronic address: drtsai1208@gmail.com.
authors.forename: Ming-Han
authors.initials: MH
authors.lastname: Tsai
mesh_terms: D000293:Adolescent; D001062:Appendectomy; D001064:Appendicitis / Q000097:blood* / Q000175:diagnosis* / Q000628:therapy; D002097:C-Reactive Protein / Q000378:metabolism*; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D011237:Predictive Value of Tests; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; children; recurrent appendicitis