Dataset Information

Meaningful standard of reference for appendiceal perforation: pathology, surgery, or both?

ABSTRACT:

Purpose

This retrospective study was aimed to determine if appendiceal perforation identified pathologically but not surgically is clinically meaningful.

Methods

The study consists of 2 parts. First, we reviewed 74 studies addressing appendiceal perforation published in 2012 and 2013. Second, in a cross-sectional study, we classified 1,438 adolescents and adults (mean age, 29.3 ± 8.4 years; 785 men) with confirmed appendicitis as "nonperforation" (n = 1,083, group 1), "pathologically-identified perforation" (n = 55, group 2), "surgically-identified perforation" (n = 202, group 3), or "pathologically- and surgically-identified perforation" (n = 98, group 4). The 4 groups were compared for the frequency of laparoscopic appendectomy and the length of hospital stay using multivariable logistic regression analyses.

Results

The reference standard for appendiceal perforation was frequently missing or inconsistent in the previous studies. Laparoscopic appendectomies were less frequent in groups 3 (52.5%, P = 0.001) and 4 (65%, P = 0.040) than in group 1 (70.7%), while group 2 (73%, P = 0.125) did not significantly differ from group 1. Median hospital stays were 2.9, 3.0, 5.1, and 6.0 days for groups 1-4, respectively. Prolonged hospital stay (?3.7 days) was more frequent in groups 3 (77.7%, P < 0.001) and 4 (89%, P < 0.001) than in group 1 (23.4%), while group 2 (35%, P = 0.070) did not significantly differ from group 1.

Conclusion

We recommend using surgical rather than pathologic findings as the reference standard for the presence of appendiceal perforation in future investigations.

SUBMITTER: Kim HJ

PROVIDER: S-EPMC5566752 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Publications

Meaningful standard of reference for appendiceal perforation: pathology, surgery, or both?

Kim Hyuk Jung HJ Kim Mi Sung MS Park Ji Hoon JH Ahn Soyeon S Ko Yousun Y Song Soon-Young SY Woo Ji Young JY Lee Kyoung Ho KH

Annals of surgical treatment and research 20170728 2

<h4>Purpose</h4>This retrospective study was aimed to determine if appendiceal perforation identified pathologically but not surgically is clinically meaningful.<h4>Methods</h4>The study consists of 2 parts. First, we reviewed 74 studies addressing appendiceal perforation published in 2012 and 2013. Second, in a cross-sectional study, we classified 1,438 adolescents and adults (mean age, 29.3 ± 8.4 years; 785 men) with confirmed appendicitis as "nonperforation" (n = 1,083, group 1), "pathologica ...[more]

PMID: 28835885

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Dataset Information

Meaningful standard of reference for appendiceal perforation: pathology, surgery, or both?

Purpose

Methods

Results

Conclusion

Publications

Meaningful standard of reference for appendiceal perforation: pathology, surgery, or both?

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