Abstract
Among patients with an acute abdomen, acute appendicitis is the most frequent disease. Acute appendicitis is generally treated by early operation, however, all patients with the disease are not always candidates for early operation. In this paper, we report on a study of clinical factors which can predict perforative and/or gangrenous appendicitis (complicated appendicitis) that requires rapid emergency operation. The study enrolled a total of 172 patients operated on in our department with a diagnosis of acute appendicitis in a four-year period from January 2009 to December 2012. A multivariate analysis revealed three independent factors predicting complicated appendicitis preoperatively ; namely, fluid collection surrounding the appendix (p=0.008, Odd ratio=3.175), CRP of more than 4.7 mg/dl (p=0.009, Odd ratio=3.979) and the body temperature at admission of more than 37.4°C (p=0.045, Odd ratio=2.400). About 97% of patients who did not satisfy all the three factors had catarrhal or phlegmonous appendicitis. In these patients, night emergency operation could be avoided even if they might be candidates for operation.
