Effect of time to the risk of perforation in pediatric appendicitis

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Published: Apr 17, 2018
Keywords:
ruptured appendicitis time factor

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Wasun Nuntasunti
Medical Physicial, Professional Level, Division of Pediatric Surgery, Department of Surgery, Sisaket hospital, Sisaket, Thailand Correspondence to: Wasun Nuntasunti, Division of Pediatric Surgery, Department of Surgery, Sisaket hospital, Sisaket, Thailand 33000

Abstract

Background: Pediatric appendicitis has high perforation rate which relatively dependedon onset time.
Objective: To demonstrate the effect of time to the risk of perforation in pediatricappendicitis.
Study design: A retrospective cohort study of children with acute appendicitis.
Setting: Sisaket hospital
Material and Methods: Chart review of children with acute appendicitis from 2014-2015 was conducted in correlation with histopathology. Conditional risks of perforation were calculated using life table methods. Logistic regression was used to assess factors associated with perforation.
Results: The perforation rate was 22% in 150 patients with acute appendicitis.Perforation risk was 5% in patients with onset time 36-48 hours. For patients with onset time 108-120 hours, perforation risk was 67% or 8% per hour. Median survival time was 68.13 hours. เท logistic regression analysis, factors associate for perforation risk were found to be prior oral antibiotic treat­ment, patient delay time (hours) and temperature (°c) with OR 4.18 (95% Cl: 1.65-10.59), OR 1.03 (95% Cl: 1.01-1.05), OR 3.54 (95% Cl: 1.95-6.43) respectively.
Conclusion: Physicians should be cautious about delaying surgery beyond onset time108 hours in children with appendicitis. National campaign for proper use of antibiotics and education for acute appendicitis should be considered.

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How to Cite
Nuntasunti, W. (2018). Effect of time to the risk of perforation in pediatric appendicitis. MEDICAL JOURNAL OF SISAKET SURIN BURIRAM HOSPITALS, 31(3), 149–162. retrieved from https://he02.tci-thaijo.org/index.php/MJSSBH/article/view/118999
Issue
Vol. 31 No. 3 (2016): September - December 2016
Section
Original Articles

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