Risk factors for developing intra-abdominal abscess following appendicectomy for acute appendicitis: a retrospective cohort study
Background Laparoscopic appendicectomy is commonly performed in Australia for treatment of acute appendicitis. Intra-abdominal abscess (IAA) is a potential complication following appendicectomy for acute appendicitis. Risk factors for developing post-operative IAA remain controversial and poorly def...
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| Veröffentlicht in: | Langenbeck's archives of surgery 2024-08, Vol.409 (1), p.246, Article 246 |
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| creator | Mao, B P Collins, G Ayeni, F E Vagg, D J |
| description | Background
Laparoscopic appendicectomy is commonly performed in Australia for treatment of acute appendicitis. Intra-abdominal abscess (IAA) is a potential complication following appendicectomy for acute appendicitis. Risk factors for developing post-operative IAA remain controversial and poorly defined. Laparoscopic washout may be performed for patients who develop complication(s) including IAA. The aim of this study was to define risk factors for both the development of IAA and identify patients who may require laparoscopic washout following appendicectomy.
Methods
Data were obtained from 423 patients who underwent laparoscopic appendicectomy over a five-year period (2012–2017). Clinical (fever, haemodynamics, examination findings), biochemical (white cell count, neutrophil count, C-reactive protein, bilirubin, albumin), radiological (CT free fluid), and operative factors (inflammation, suppuration, free-fluid, perforation, histopathology) collected in the pre-, peri-, and post-operative period(s) were analysed.
Results
23 (5.4%) patients developed post-operative IAA. Duration of intravenous antibiotics was significantly longer in patients who developed IAA and in those who required laparoscopic washout (
p
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| doi_str_mv | 10.1007/s00423-024-03421-w |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_11315757</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3090950234</sourcerecordid><originalsourceid>FETCH-LOGICAL-c284t-900248871130707685d719278b25b8abb0c126279b343a5fc594a122a666b103</originalsourceid><addsrcrecordid>eNp9Uctu1DAUtRCIttP-AAvkJZvA9StO2CBUAUWqVAl1b9mOM3VJ4mA7M5pl_xxPp4zKpitbOi8fH4TeEfhIAOSnBMApq4DyChinpNq-QqeEM1FRLsjrZ_cTdJbSPQDUsuVv0QlrCYWa8FP08Mun37jXNoeYcB8i7tzGDWH20xr7KUddadOF0U96wNok69KeNgxhu2foeXZT560r-nH3qNd2ye4I-OzTZ6xxdDmGNBee3zhsw12IGae8dLtz9KbXQ3IXT-cK3X7_dnt5VV3f_Ph5-fW6srThuWqh9GwaSQgDCbJuRCdJS2VjqDCNNgYsoTWVrWGcadFb0XJNKNV1XRsCbIW-HGznxYyus27fbVBz9KOOOxW0V_8jk79T67BRJZAIKWRx-PDkEMOfxaWsRl_-Yxj05MKSFIMWWgG05K8QPVBtKZ2i6485BNR-O3XYTpVO6nE7tS2i989feJT8G6sQ2IGQCjStXVT3YYllmPSS7V-x_6gL</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>3090950234</pqid></control><display><type>article</type><title>Risk factors for developing intra-abdominal abscess following appendicectomy for acute appendicitis: a retrospective cohort study</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Mao, B P ; Collins, G ; Ayeni, F E ; Vagg, D J</creator><creatorcontrib>Mao, B P ; Collins, G ; Ayeni, F E ; Vagg, D J</creatorcontrib><description>Background
Laparoscopic appendicectomy is commonly performed in Australia for treatment of acute appendicitis. Intra-abdominal abscess (IAA) is a potential complication following appendicectomy for acute appendicitis. Risk factors for developing post-operative IAA remain controversial and poorly defined. Laparoscopic washout may be performed for patients who develop complication(s) including IAA. The aim of this study was to define risk factors for both the development of IAA and identify patients who may require laparoscopic washout following appendicectomy.
Methods
Data were obtained from 423 patients who underwent laparoscopic appendicectomy over a five-year period (2012–2017). Clinical (fever, haemodynamics, examination findings), biochemical (white cell count, neutrophil count, C-reactive protein, bilirubin, albumin), radiological (CT free fluid), and operative factors (inflammation, suppuration, free-fluid, perforation, histopathology) collected in the pre-, peri-, and post-operative period(s) were analysed.
Results
23 (5.4%) patients developed post-operative IAA. Duration of intravenous antibiotics was significantly longer in patients who developed IAA and in those who required laparoscopic washout (
p
< 0.0001). C-reactive protein (CRP) on admission (
p
< 0.05) and appendiceal perforation (
p
= 0.0005) were significantly higher in patients who either developed IAA or needed laparoscopic washout. No clinical or radiological finding predicted either the development of IAA or need for laparoscopic washout.
Conclusion
Elevated CRP on admission may predict the development of post-operative IAA formation or the need for laparoscopic washout post-appendicectomy. Prolonged post-operative antibiotic use appears independent of the development of IAA as well as the need for laparoscopic washout. These data highlight the need for clear guidelines on peri-operative antibiotic use following appendicectomy.</description><identifier>ISSN: 1435-2451</identifier><identifier>ISSN: 1435-2443</identifier><identifier>EISSN: 1435-2451</identifier><identifier>DOI: 10.1007/s00423-024-03421-w</identifier><identifier>PMID: 39120614</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Abdominal Abscess - etiology ; Abdominal Surgery ; Acute Disease ; Adolescent ; Adult ; Aged ; Appendectomy - adverse effects ; Appendicitis - surgery ; C-Reactive Protein - analysis ; Cardiac Surgery ; Cohort Studies ; Female ; General Surgery ; Humans ; Laparoscopy - adverse effects ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Postoperative Complications - epidemiology ; Postoperative Complications - etiology ; Retrospective Studies ; Risk Factors ; Thoracic Surgery ; Traumatic Surgery ; Vascular Surgery ; Young Adult</subject><ispartof>Langenbeck's archives of surgery, 2024-08, Vol.409 (1), p.246, Article 246</ispartof><rights>The Author(s) 2024</rights><rights>2024. The Author(s).</rights><rights>The Author(s) 2024 2024</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c284t-900248871130707685d719278b25b8abb0c126279b343a5fc594a122a666b103</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00423-024-03421-w$$EPDF$$P50$$Gspringer$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00423-024-03421-w$$EHTML$$P50$$Gspringer$$Hfree_for_read</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/39120614$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Mao, B P</creatorcontrib><creatorcontrib>Collins, G</creatorcontrib><creatorcontrib>Ayeni, F E</creatorcontrib><creatorcontrib>Vagg, D J</creatorcontrib><title>Risk factors for developing intra-abdominal abscess following appendicectomy for acute appendicitis: a retrospective cohort study</title><title>Langenbeck's archives of surgery</title><addtitle>Langenbecks Arch Surg</addtitle><addtitle>Langenbecks Arch Surg</addtitle><description>Background
Laparoscopic appendicectomy is commonly performed in Australia for treatment of acute appendicitis. Intra-abdominal abscess (IAA) is a potential complication following appendicectomy for acute appendicitis. Risk factors for developing post-operative IAA remain controversial and poorly defined. Laparoscopic washout may be performed for patients who develop complication(s) including IAA. The aim of this study was to define risk factors for both the development of IAA and identify patients who may require laparoscopic washout following appendicectomy.
Methods
Data were obtained from 423 patients who underwent laparoscopic appendicectomy over a five-year period (2012–2017). Clinical (fever, haemodynamics, examination findings), biochemical (white cell count, neutrophil count, C-reactive protein, bilirubin, albumin), radiological (CT free fluid), and operative factors (inflammation, suppuration, free-fluid, perforation, histopathology) collected in the pre-, peri-, and post-operative period(s) were analysed.
Results
23 (5.4%) patients developed post-operative IAA. Duration of intravenous antibiotics was significantly longer in patients who developed IAA and in those who required laparoscopic washout (
p
< 0.0001). C-reactive protein (CRP) on admission (
p
< 0.05) and appendiceal perforation (
p
= 0.0005) were significantly higher in patients who either developed IAA or needed laparoscopic washout. No clinical or radiological finding predicted either the development of IAA or need for laparoscopic washout.
Conclusion
Elevated CRP on admission may predict the development of post-operative IAA formation or the need for laparoscopic washout post-appendicectomy. Prolonged post-operative antibiotic use appears independent of the development of IAA as well as the need for laparoscopic washout. These data highlight the need for clear guidelines on peri-operative antibiotic use following appendicectomy.</description><subject>Abdominal Abscess - etiology</subject><subject>Abdominal Surgery</subject><subject>Acute Disease</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Appendectomy - adverse effects</subject><subject>Appendicitis - surgery</subject><subject>C-Reactive Protein - analysis</subject><subject>Cardiac Surgery</subject><subject>Cohort Studies</subject><subject>Female</subject><subject>General Surgery</subject><subject>Humans</subject><subject>Laparoscopy - adverse effects</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Postoperative Complications - epidemiology</subject><subject>Postoperative Complications - etiology</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Thoracic Surgery</subject><subject>Traumatic Surgery</subject><subject>Vascular Surgery</subject><subject>Young Adult</subject><issn>1435-2451</issn><issn>1435-2443</issn><issn>1435-2451</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2024</creationdate><recordtype>article</recordtype><sourceid>C6C</sourceid><sourceid>EIF</sourceid><recordid>eNp9Uctu1DAUtRCIttP-AAvkJZvA9StO2CBUAUWqVAl1b9mOM3VJ4mA7M5pl_xxPp4zKpitbOi8fH4TeEfhIAOSnBMApq4DyChinpNq-QqeEM1FRLsjrZ_cTdJbSPQDUsuVv0QlrCYWa8FP08Mun37jXNoeYcB8i7tzGDWH20xr7KUddadOF0U96wNok69KeNgxhu2foeXZT560r-nH3qNd2ye4I-OzTZ6xxdDmGNBee3zhsw12IGae8dLtz9KbXQ3IXT-cK3X7_dnt5VV3f_Ph5-fW6srThuWqh9GwaSQgDCbJuRCdJS2VjqDCNNgYsoTWVrWGcadFb0XJNKNV1XRsCbIW-HGznxYyus27fbVBz9KOOOxW0V_8jk79T67BRJZAIKWRx-PDkEMOfxaWsRl_-Yxj05MKSFIMWWgG05K8QPVBtKZ2i6485BNR-O3XYTpVO6nE7tS2i989feJT8G6sQ2IGQCjStXVT3YYllmPSS7V-x_6gL</recordid><startdate>20240809</startdate><enddate>20240809</enddate><creator>Mao, B P</creator><creator>Collins, G</creator><creator>Ayeni, F E</creator><creator>Vagg, D J</creator><general>Springer Berlin Heidelberg</general><scope>C6C</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>5PM</scope></search><sort><creationdate>20240809</creationdate><title>Risk factors for developing intra-abdominal abscess following appendicectomy for acute appendicitis: a retrospective cohort study</title><author>Mao, B P ; Collins, G ; Ayeni, F E ; Vagg, D J</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c284t-900248871130707685d719278b25b8abb0c126279b343a5fc594a122a666b103</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2024</creationdate><topic>Abdominal Abscess - etiology</topic><topic>Abdominal Surgery</topic><topic>Acute Disease</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Appendectomy - adverse effects</topic><topic>Appendicitis - surgery</topic><topic>C-Reactive Protein - analysis</topic><topic>Cardiac Surgery</topic><topic>Cohort Studies</topic><topic>Female</topic><topic>General Surgery</topic><topic>Humans</topic><topic>Laparoscopy - adverse effects</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Postoperative Complications - epidemiology</topic><topic>Postoperative Complications - etiology</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Thoracic Surgery</topic><topic>Traumatic Surgery</topic><topic>Vascular Surgery</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mao, B P</creatorcontrib><creatorcontrib>Collins, G</creatorcontrib><creatorcontrib>Ayeni, F E</creatorcontrib><creatorcontrib>Vagg, D J</creatorcontrib><collection>Springer Nature OA Free Journals</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Langenbeck's archives of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Mao, B P</au><au>Collins, G</au><au>Ayeni, F E</au><au>Vagg, D J</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Risk factors for developing intra-abdominal abscess following appendicectomy for acute appendicitis: a retrospective cohort study</atitle><jtitle>Langenbeck's archives of surgery</jtitle><stitle>Langenbecks Arch Surg</stitle><addtitle>Langenbecks Arch Surg</addtitle><date>2024-08-09</date><risdate>2024</risdate><volume>409</volume><issue>1</issue><spage>246</spage><pages>246-</pages><artnum>246</artnum><issn>1435-2451</issn><issn>1435-2443</issn><eissn>1435-2451</eissn><abstract>Background
Laparoscopic appendicectomy is commonly performed in Australia for treatment of acute appendicitis. Intra-abdominal abscess (IAA) is a potential complication following appendicectomy for acute appendicitis. Risk factors for developing post-operative IAA remain controversial and poorly defined. Laparoscopic washout may be performed for patients who develop complication(s) including IAA. The aim of this study was to define risk factors for both the development of IAA and identify patients who may require laparoscopic washout following appendicectomy.
Methods
Data were obtained from 423 patients who underwent laparoscopic appendicectomy over a five-year period (2012–2017). Clinical (fever, haemodynamics, examination findings), biochemical (white cell count, neutrophil count, C-reactive protein, bilirubin, albumin), radiological (CT free fluid), and operative factors (inflammation, suppuration, free-fluid, perforation, histopathology) collected in the pre-, peri-, and post-operative period(s) were analysed.
Results
23 (5.4%) patients developed post-operative IAA. Duration of intravenous antibiotics was significantly longer in patients who developed IAA and in those who required laparoscopic washout (
p
< 0.0001). C-reactive protein (CRP) on admission (
p
< 0.05) and appendiceal perforation (
p
= 0.0005) were significantly higher in patients who either developed IAA or needed laparoscopic washout. No clinical or radiological finding predicted either the development of IAA or need for laparoscopic washout.
Conclusion
Elevated CRP on admission may predict the development of post-operative IAA formation or the need for laparoscopic washout post-appendicectomy. Prolonged post-operative antibiotic use appears independent of the development of IAA as well as the need for laparoscopic washout. These data highlight the need for clear guidelines on peri-operative antibiotic use following appendicectomy.</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>39120614</pmid><doi>10.1007/s00423-024-03421-w</doi><oa>free_for_read</oa></addata></record> |
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| source | MEDLINE; SpringerNature Journals |
| subjects | Abdominal Abscess - etiology Abdominal Surgery Acute Disease Adolescent Adult Aged Appendectomy - adverse effects Appendicitis - surgery C-Reactive Protein - analysis Cardiac Surgery Cohort Studies Female General Surgery Humans Laparoscopy - adverse effects Male Medicine Medicine & Public Health Middle Aged Postoperative Complications - epidemiology Postoperative Complications - etiology Retrospective Studies Risk Factors Thoracic Surgery Traumatic Surgery Vascular Surgery Young Adult |
| title | Risk factors for developing intra-abdominal abscess following appendicectomy for acute appendicitis: a retrospective cohort study |
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