An Examination of Predictors of Necrotizing and Perforated Appendicitis After Surgery

Abstract

【Purpose】We retrospectively examined the predicting factors of necrotizing/perforated appendicitis from the preoperative findings including the imaging diagnosis of acute appendicitis surgery cases. Age, body temperature, muscle protection, white blood cell count, CRP levels, CT findings (appendicolith, appendix swelling, elevated fat tissue density around the appendix, ascites) associated with 368 cases of appendectomy from April 2005 to December 2009 were divided into two groups and predictors for necrotizing and perforated appendicitis were assessed using binomial logistic analysis. One hundred and eighty-nine cases (51.4％) of necrotizing and perforated appendicitis were identified. A univariate analysis revealed that predictors for necrotizing/perforated appendicitis were body temperature, muscle protection, CRP levels, elevated fat tissue density around the appendix of CT findings, and ascites. A multivariate analysis findings showed three factors: CRP levels, body temperature, and elevated fat tissue density around the appendix of CT. The probability of having necrotizing/perforating appendicitis was 75.5％ for cases with 2 positive factors and 92.3％ for 3. Based on our results, if more than one of the above factors is positive, prioritizing surgical treatment should be considered as necessary.