Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study

6533b85bfe1ef96bd12bac4f

RESEARCH PRODUCT

Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study

Gaetano Poillucci Mauro Podda Adolfo Pisanu Lorenzo Mortola Patrizia Dalla Caneva Giulia Massa Gianluca Costa Riccardo Savastano Nicola Cillara Collaborative Study Group Endorsed By Sicut Acoi Sicg Sice And Italian Chapter Of Wses F Agresta G Alemanno G Anania M Antropoli G Argenio J Atzeni N Avenia A Azzinnaro G Baldazzi G Balducci G Barbera G Bellanova C Bergamini L Bersigotti Pp Bianchi C Bombardini G Borzellino S Bozzo G Brachini Gm Buonanno T Canini S Cardella G Carrara D Cassini M Castriconi G Ceccarelli D Celi M Ceresoli M Chiarugi N Cillara F Cimino L Cobuccio G Cocorullo E Colangelo G Costa A Crucitti P Dalla Caneva M De Luca A De Manzoni Garberini C De Nisco M De Prizio A De Sol A Dibella T Falcioni N Falco C Farina E Finotti T Fontana G Francioni P Fransvea B Frezza G Garulli M Genna S Giannessi A Gioffrè A Giordano D Gozzo S Grimaldi G Gulotta V Iacopini T Iarussi E Laterza A Leonardi L Lepre L Lorenzon G Luridiana A Malagnino G Mar P Marini R Marzaioli G Massa V Mecarelli A Mingoli G Nigri S Occhionorelli N Paderno Gm Palini D Paradies M Paroli F Perrone L Petruzzelli A Pezzolla D Piazza V Piazza M Piccoli A Pisanu M Podda G Poillucci R Porfidia G Rossi P Ruscelli A Spagnoli R Sulis D Tartaglia C Tranà A Travaglino P Tomaiuolo A Valeri G Vasquez M Zago E. Zanoni

subject

medicine.medical_specialty Multivariate analysis Sports medicine Settore MED/18 - CHIRURGIA GENERALE Critical Care and Intensive Care Medicine Acute appendicitis; Appendectomy; Elderly; Frail patients; Postoperative complications NO Postoperative complications 03 medical and health sciences chemistry.chemical_compound Elderly 0302 clinical medicine Risk Factors Acute appendicitis Appendectomy Elderly Frail patients Postoperative complications Internal medicine medicine Humans Appendectomy Frail patient Orthopedics and Sports Medicine In patient Prospective Studies Prospective cohort study Aged Retrospective Studies Acute appendicitis 030222 orthopedics Creatinine business.industry Postoperative complication 030208 emergency & critical care medicine Perioperative Length of Stay Appendicitis Postoperative complication chemistry Emergency Medicine Laparoscopy Surgery Acute appendiciti Morbidity Risk assessment business Frail patients

description

Background: A limited number of studies investigating perioperative risk factors associated with emergency appendectomy in elderly patients have been published to date. Whether older age may be associated with poorer outcomes following appendectomy is still a matter of debate. The primary aim of this study was to determine the predictors of postoperative morbidity following appendectomy in patients aged ≥ 65 years. Methods: Data regarding all elderly patients who underwent emergency appendectomy from January 2017 to June 2018 admitted 36 Italian surgical departments were prospectively collected and analyzed. Baseline demographics and perioperative variables were evaluated. Uni- and multivariate analyses adjusted for differences between groups were carried out to determine possible predictors of adverse outcomes after appendectomy. Results: Between January 2017 and June 2018, 135 patients aged ≥ 65 years with a diagnosis of AA met the study inclusion criteria. Twenty-six patients (19.3%) were diagnosed with some type of postoperative complication. Decreasing the preoperative hemoglobin level showed a statistically significant association with postoperative complications (OR 0.77, CI 0.61–0.97, P = 0.03). Preoperative creatinine level (P = 0.02, OR 2.04, CI 1.12–3.72), and open appendectomy (P = 0.03, OR 2.67, CI 1.11–6.38) were significantly associated with postoperative morbidity. After adjustment, the only independent predictor of postoperative morbidity was preoperative creatinine level (P = 0.04, OR 2.01, CI 1.05–3.89). Conclusions: In elderly patients with AA, perioperative risk assessment in the emergency setting must be as accurate as possible to identify modifiable risk factors that can be addressed before surgery, such as preoperative hemoglobin and creatinine levels.

year	journal	country	edition	language
2019-07-15	European Journal of Trauma and Emergency Surgery

https://doi.org/10.1007/s00068-019-01186-2