Dataset Information

Perforated appendicitis in patients with schizophrenia: a retrospective cohort study.

ABSTRACT:

Objective

Altered pain sensitivity may affect the outcome of appendicitis in patients with schizophrenia. We aimed to compare the prevalence of perforation in appendicitis between patients with and without schizophrenia.

Design

Retrospective cohort study with random matching.

Setting

A single tertiary medical centre in Japan.

Participants

From 1985 to 2013, 1821 cases of appendicitis requiring appendectomy were collected. Patients with schizophrenia and a cohort of randomly selected control subjects without schizophrenia who underwent appendectomy were identified.

Primary and secondary outcome measures

The primary outcome was the rate of perforated appendicitis in patients with and without schizophrenia. Secondary outcome was the odds of perforated appendicitis by different clinical factors.

Results

62 patients with schizophrenia and randomly sampled 200 non-schizophrenic patients were compared. The prevalence of perforation was 53% in patients with schizophrenia versus 17% in controls (p<0.0001). The adjusted OR for perforation were 4.87 (95% CI: 2.33 to 10.2) for schizophrenia, 3.35 (95% CI 1.51 to 7.45) for age >55 years and 2.18 (95% CI: 1.12 to 4.27) for delayed presentation.

Conclusion

Appendiceal perforation was more frequent in patients with schizophrenia than controls, which may be partly attributable to delayed presentation and altered responses to pain.

SUBMITTER: Nishihira Y

PROVIDER: S-EPMC5623499 | biostudies-literature | 2017 Sep

REPOSITORIES: biostudies-literature

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Publications

Perforated appendicitis in patients with schizophrenia: a retrospective cohort study.

Nishihira Yoshimasa Y McGill Rita L RL Kinjo Mitsuyo M

BMJ open 20170925 9

<h4>Objective</h4>Altered pain sensitivity may affect the outcome of appendicitis in patients with schizophrenia. We aimed to compare the prevalence of perforation in appendicitis between patients with and without schizophrenia.<h4>Design</h4>Retrospective cohort study with random matching.<h4>Setting</h4>A single tertiary medical centre in Japan.<h4>Participants</h4>From 1985 to 2013, 1821 cases of appendicitis requiring appendectomy were collected. Patients with schizophrenia and a cohort of r ...[more]

PMID: 28951411

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Project description:BackgroundAcute appendicitis is the most frequent non-obstetric surgical emergency during pregnancy. The benefits of laparoscopy during pregnancy are well known, but complications can occur, and these can affect both the mother and/or the foetus.We present results of laparoscopic surgical treatment of acute appendicitis in pregnant women, analysing the occurrence of adverse postoperative, obstetric and foetal outcomes and reviewing literature.Materials and methodsRetrospective observational study on pregnant women with a preoperative diagnosis of acute appendicitis.Resultsn = 63, mean age 28.4 years, average gestational age of 17.7 weeks (3-30 weeks). 6.4 % exploratory laparoscopies, 92 % laparoscopic appendectomies and one right colectomy were performed. Conversion rate was 3.2 %. When symptoms begun within 48 hours prior to surgery, a perforated appendicitis was found in 11 %; whereas when the time from symptom onset to surgery was greater than or equal to 48 hours, it was evident in 31 % of the cases (p 0.008). The only independent variable associated with the presence of postoperative complications was symptom duration prior to surgery greater than or equal to 48 hours (OR 4.8; 95 % CI 1.1-16.2; p 0.04). Seven minor and 2 mayor postoperative complications were observed. Patients with complications spent, on average, twice as many days hospitalized (p < 0.001); and had 8 times more risk of preterm delivery (p 0.03). Obstetric complications were more frequent in pregnant women operated during the first trimester. Foetal mortality was 1.6 %.ConclusionSurgical morbidity of acute appendicitis in pregnant women is linked to the delay in the diagnosis and treatment of the inflammatory condition. Laparoscopic appendectomy during pregnancy is not exempt from postoperative, obstetric and foetal complications. It is necessary to standardize the definitions of "complication" in order to collate reliably the outcomes presented in the literature.

Dataset Information

Perforated appendicitis in patients with schizophrenia: a retrospective cohort study.

Objective

Design

Setting

Participants

Primary and secondary outcome measures

Results

Conclusion

Publications

Perforated appendicitis in patients with schizophrenia: a retrospective cohort study.

Similar Datasets

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