A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess

Masatsugu Hiraki; Toshiya Tanaka; Kohei Yamada; Eiji Sadashima; Tatsuya Manabe; Kenji Kitahara; Hirokazu Noshiro

doi:doi:10.11648/j.js.20200801.14

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A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess

Masatsugu Hiraki, Toshiya Tanaka, Kohei Yamada, Eiji Sadashima, Tatsuya Manabe, Kenji Kitahara, Hirokazu Noshiro

Published in Journal of Surgery (Volume 8, Issue 1)

Received: 10 January 2020 Accepted: 21 January 2020 Published: 7 February 2020

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Abstract

Background: The aim of the present study was to investigate risk factors and predictive factors for prolonged hospitalization in adults undergoing non-surgical treatment for appendiceal abscess. Patients and Methods: A retrospective study was conducted of consecutive patients who underwent treatment following a diagnosis of appendicitis in a single institution. Between January 2008 and May 2019, 756 adult patients who were diagnosed with acute appendicitis, 101 of these patients (13.4%) had an appendiceal abscess and were treated as inpatients. The treatments of these patients were as follows: non-surgical treatment alone (n=45), emergency operation (n=50) and conversion to emergency operation due to failure of the initial conservative therapy (n=6). The present study analyzed the 45 patients managed with non-surgical treatment alone. The patients were divided, based on the median length of the hospital stay (nine day), into the shorter hospital stay and longer hospital stay groups. The risk factors and predictive factors for prolonged hospitalization were examined in the two groups. Results: Twenty-four patients were classified into the shorter hospital stay group and 21 were classified into the longer hospital stay group. A univariate analysis demonstrated that the body temperature on post-admission days 2 (P=0.012) and 3 (P=0.008), were significantly associated with the length of hospital stay. A multivariate logistic regression analysis using that the body temperature on post-admission day 3 tended to be associated with prolonged hospitalization (odds ratio=8.574, 95% confidence interval=0.973-75.525; P=0.053). The cut-off value of the body temperature on day 3, determined by an ROC curve analysis, was 37.05°C. This cut-off value showed 66.7% accuracy, 57.1% sensitivity and 75.0% specificity. Conclusion: The body temperature on post-admission day 3 might be a potential risk factor and predictive marker for prolonged hospitalization in patients who receive non-surgical treatment for appendiceal abscess.

Published in	Journal of Surgery (Volume 8, Issue 1)
DOI	10.11648/j.js.20200801.14
Page(s)	16-21
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Appendiceal Abscess, Appendicular Abscess, Non-Surgical Treatment, Appendicitis, Interval Appendectomy

References

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[2]	Sadakari Y, Date S, Murakami S et al. Prediction of negative outcomes in non-surgical treatment for appendiceal abscess in adults. J Anus Rectum Colon 2018; 2: 59-65.
[3]	de Jonge J, Bolmers MDM, Musters GD et al. Predictors for interval appendectomy in non-operatively treated complicated appendicitis. Int J Colorectal Dis 2019; 34: 1325-1332.
[4]	Di Saverio S, Birindelli A, Kelly MD et al. WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis. World J Emerg Surg 2016; 11: 34.
[5]	Gorter RR, Eker HH, Gorter-Stam MA et al. Diagnosis and management of acute appendicitis. EAES consensus development conference 2015. Surg Endosc 2016; 30: 4668-4690.
[6]	Simillis C, Symeonides P, Shorthouse AJ, Tekkis PP. A meta-analysis comparing conservative treatment versus acute appendectomy for complicated appendicitis (abscess or phlegmon). Surgery 2010; 147: 818-829.
[7]	Shekarriz S, Keck T, Kujath P et al. Comparison of conservative versus surgical therapy for acute appendicitis with abscess in five German hospitals. Int J Colorectal Dis 2019; 34: 649-655.
[8]	Mentula P, Sammalkorpi H, Leppaniemi A. Laparoscopic Surgery or Conservative Treatment for Appendiceal Abscess in Adults? A Randomized Controlled Trial. Ann Surg 2015; 262: 237-242.
[9]	Quah GS, Eslick GD, Cox MR. Laparoscopic appendicectomy is superior to open surgery for complicated appendicitis. Surg Endosc 2019; 33: 2072-2082.
[10]	Nimmagadda N, Matsushima K, Piccinini A et al. Complicated appendicitis: Immediate operation or trial of nonoperative management? Am J Surg 2019; 217: 713-717.
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[12]	Watanabe R, Otsuji A, Nakamura Y et al. Superior outcomes (but at higher costs) of non-operative management with interval appendectomy over immediate surgery in appendicitis with abscess: Results from a large adult population cohort. Asian J Endosc Surg 2019.
[13]	Chen CL, Chao HC, Kong MS, Chen SY. Risk Factors for Prolonged Hospitalization in Pediatric Appendicitis Patients with Medical Treatment. Pediatr Neonatol 2017; 58: 223-228.
[14]	Kim DH, Kim HJ, Jang SK et al. CT Predictors of Unfavorable Clinical Outcomes of Acute Right Colonic Diverticulitis. AJR Am J Roentgenol 2017; 209: 1263-1271.
[15]	Mali J, Mentula P, Leppaniemi A, Sallinen V. Determinants of treatment and outcomes of diverticular abscesses. World J Emerg Surg 2019; 14: 31.

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APA Style

Masatsugu Hiraki, Toshiya Tanaka, Kohei Yamada, Eiji Sadashima, Tatsuya Manabe, et al. (2020). A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess. Journal of Surgery, 8(1), 16-21. https://doi.org/10.11648/j.js.20200801.14

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ACS Style

Masatsugu Hiraki; Toshiya Tanaka; Kohei Yamada; Eiji Sadashima; Tatsuya Manabe, et al. A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess. J. Surg. 2020, 8(1), 16-21. doi: 10.11648/j.js.20200801.14

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AMA Style

Masatsugu Hiraki, Toshiya Tanaka, Kohei Yamada, Eiji Sadashima, Tatsuya Manabe, et al. A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess. J Surg. 2020;8(1):16-21. doi: 10.11648/j.js.20200801.14

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@article{10.11648/j.js.20200801.14,
  author = {Masatsugu Hiraki and Toshiya Tanaka and Kohei Yamada and Eiji Sadashima and Tatsuya Manabe and Kenji Kitahara and Hirokazu Noshiro},
  title = {A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess},
  journal = {Journal of Surgery},
  volume = {8},
  number = {1},
  pages = {16-21},
  doi = {10.11648/j.js.20200801.14},
  url = {https://doi.org/10.11648/j.js.20200801.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200801.14},
  abstract = {Background: The aim of the present study was to investigate risk factors and predictive factors for prolonged hospitalization in adults undergoing non-surgical treatment for appendiceal abscess. Patients and Methods: A retrospective study was conducted of consecutive patients who underwent treatment following a diagnosis of appendicitis in a single institution. Between January 2008 and May 2019, 756 adult patients who were diagnosed with acute appendicitis, 101 of these patients (13.4%) had an appendiceal abscess and were treated as inpatients. The treatments of these patients were as follows: non-surgical treatment alone (n=45), emergency operation (n=50) and conversion to emergency operation due to failure of the initial conservative therapy (n=6). The present study analyzed the 45 patients managed with non-surgical treatment alone. The patients were divided, based on the median length of the hospital stay (nine day), into the shorter hospital stay and longer hospital stay groups. The risk factors and predictive factors for prolonged hospitalization were examined in the two groups. Results: Twenty-four patients were classified into the shorter hospital stay group and 21 were classified into the longer hospital stay group. A univariate analysis demonstrated that the body temperature on post-admission days 2 (P=0.012) and 3 (P=0.008), were significantly associated with the length of hospital stay. A multivariate logistic regression analysis using that the body temperature on post-admission day 3 tended to be associated with prolonged hospitalization (odds ratio=8.574, 95% confidence interval=0.973-75.525; P=0.053). The cut-off value of the body temperature on day 3, determined by an ROC curve analysis, was 37.05°C. This cut-off value showed 66.7% accuracy, 57.1% sensitivity and 75.0% specificity. Conclusion: The body temperature on post-admission day 3 might be a potential risk factor and predictive marker for prolonged hospitalization in patients who receive non-surgical treatment for appendiceal abscess.},
 year = {2020}
}

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TY  - JOUR
T1  - A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess
AU  - Masatsugu Hiraki
AU  - Toshiya Tanaka
AU  - Kohei Yamada
AU  - Eiji Sadashima
AU  - Tatsuya Manabe
AU  - Kenji Kitahara
AU  - Hirokazu Noshiro
Y1  - 2020/02/07
PY  - 2020
N1  - https://doi.org/10.11648/j.js.20200801.14
DO  - 10.11648/j.js.20200801.14
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 16
EP  - 21
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20200801.14
AB  - Background: The aim of the present study was to investigate risk factors and predictive factors for prolonged hospitalization in adults undergoing non-surgical treatment for appendiceal abscess. Patients and Methods: A retrospective study was conducted of consecutive patients who underwent treatment following a diagnosis of appendicitis in a single institution. Between January 2008 and May 2019, 756 adult patients who were diagnosed with acute appendicitis, 101 of these patients (13.4%) had an appendiceal abscess and were treated as inpatients. The treatments of these patients were as follows: non-surgical treatment alone (n=45), emergency operation (n=50) and conversion to emergency operation due to failure of the initial conservative therapy (n=6). The present study analyzed the 45 patients managed with non-surgical treatment alone. The patients were divided, based on the median length of the hospital stay (nine day), into the shorter hospital stay and longer hospital stay groups. The risk factors and predictive factors for prolonged hospitalization were examined in the two groups. Results: Twenty-four patients were classified into the shorter hospital stay group and 21 were classified into the longer hospital stay group. A univariate analysis demonstrated that the body temperature on post-admission days 2 (P=0.012) and 3 (P=0.008), were significantly associated with the length of hospital stay. A multivariate logistic regression analysis using that the body temperature on post-admission day 3 tended to be associated with prolonged hospitalization (odds ratio=8.574, 95% confidence interval=0.973-75.525; P=0.053). The cut-off value of the body temperature on day 3, determined by an ROC curve analysis, was 37.05°C. This cut-off value showed 66.7% accuracy, 57.1% sensitivity and 75.0% specificity. Conclusion: The body temperature on post-admission day 3 might be a potential risk factor and predictive marker for prolonged hospitalization in patients who receive non-surgical treatment for appendiceal abscess.
VL  - 8
IS  - 1
ER  -

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Author Information

Masatsugu Hiraki

Department of Surgery, Saga Medical Center Koseikan, Saga, Japan
Toshiya Tanaka

Department of Surgery, Saga Medical Center Koseikan, Saga, Japan
Kohei Yamada

Department of Surgery, Saga Medical Center Koseikan, Saga, Japan
Eiji Sadashima

Life Science Research Institute, Saga Medical Center Koseikan, Saga, Japan
Tatsuya Manabe

Department of Surgery, Saga University Faculty of Medicine, Saga, Japan
Kenji Kitahara

Department of Surgery, Saga Medical Center Koseikan, Saga, Japan
Hirokazu Noshiro

Department of Surgery, Saga University Faculty of Medicine, Saga, Japan

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Plain Text BibTeX RIS

APA Style

Masatsugu Hiraki, Toshiya Tanaka, Kohei Yamada, Eiji Sadashima, Tatsuya Manabe, et al. (2020). A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess. Journal of Surgery, 8(1), 16-21. https://doi.org/10.11648/j.js.20200801.14

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ACS Style

Masatsugu Hiraki; Toshiya Tanaka; Kohei Yamada; Eiji Sadashima; Tatsuya Manabe, et al. A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess. J. Surg. 2020, 8(1), 16-21. doi: 10.11648/j.js.20200801.14

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AMA Style

Masatsugu Hiraki, Toshiya Tanaka, Kohei Yamada, Eiji Sadashima, Tatsuya Manabe, et al. A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess. J Surg. 2020;8(1):16-21. doi: 10.11648/j.js.20200801.14

Copy | Download

@article{10.11648/j.js.20200801.14,
  author = {Masatsugu Hiraki and Toshiya Tanaka and Kohei Yamada and Eiji Sadashima and Tatsuya Manabe and Kenji Kitahara and Hirokazu Noshiro},
  title = {A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess},
  journal = {Journal of Surgery},
  volume = {8},
  number = {1},
  pages = {16-21},
  doi = {10.11648/j.js.20200801.14},
  url = {https://doi.org/10.11648/j.js.20200801.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.js.20200801.14},
  abstract = {Background: The aim of the present study was to investigate risk factors and predictive factors for prolonged hospitalization in adults undergoing non-surgical treatment for appendiceal abscess. Patients and Methods: A retrospective study was conducted of consecutive patients who underwent treatment following a diagnosis of appendicitis in a single institution. Between January 2008 and May 2019, 756 adult patients who were diagnosed with acute appendicitis, 101 of these patients (13.4%) had an appendiceal abscess and were treated as inpatients. The treatments of these patients were as follows: non-surgical treatment alone (n=45), emergency operation (n=50) and conversion to emergency operation due to failure of the initial conservative therapy (n=6). The present study analyzed the 45 patients managed with non-surgical treatment alone. The patients were divided, based on the median length of the hospital stay (nine day), into the shorter hospital stay and longer hospital stay groups. The risk factors and predictive factors for prolonged hospitalization were examined in the two groups. Results: Twenty-four patients were classified into the shorter hospital stay group and 21 were classified into the longer hospital stay group. A univariate analysis demonstrated that the body temperature on post-admission days 2 (P=0.012) and 3 (P=0.008), were significantly associated with the length of hospital stay. A multivariate logistic regression analysis using that the body temperature on post-admission day 3 tended to be associated with prolonged hospitalization (odds ratio=8.574, 95% confidence interval=0.973-75.525; P=0.053). The cut-off value of the body temperature on day 3, determined by an ROC curve analysis, was 37.05°C. This cut-off value showed 66.7% accuracy, 57.1% sensitivity and 75.0% specificity. Conclusion: The body temperature on post-admission day 3 might be a potential risk factor and predictive marker for prolonged hospitalization in patients who receive non-surgical treatment for appendiceal abscess.},
 year = {2020}
}

Copy | Download

TY  - JOUR
T1  - A Retrospective Risk Analysis of Factors Associated with Prolonged Hospitalization in Adult Patients Undergoing Non-surgical Treatment for Appendiceal Abscess
AU  - Masatsugu Hiraki
AU  - Toshiya Tanaka
AU  - Kohei Yamada
AU  - Eiji Sadashima
AU  - Tatsuya Manabe
AU  - Kenji Kitahara
AU  - Hirokazu Noshiro
Y1  - 2020/02/07
PY  - 2020
N1  - https://doi.org/10.11648/j.js.20200801.14
DO  - 10.11648/j.js.20200801.14
T2  - Journal of Surgery
JF  - Journal of Surgery
JO  - Journal of Surgery
SP  - 16
EP  - 21
PB  - Science Publishing Group
SN  - 2330-0930
UR  - https://doi.org/10.11648/j.js.20200801.14
AB  - Background: The aim of the present study was to investigate risk factors and predictive factors for prolonged hospitalization in adults undergoing non-surgical treatment for appendiceal abscess. Patients and Methods: A retrospective study was conducted of consecutive patients who underwent treatment following a diagnosis of appendicitis in a single institution. Between January 2008 and May 2019, 756 adult patients who were diagnosed with acute appendicitis, 101 of these patients (13.4%) had an appendiceal abscess and were treated as inpatients. The treatments of these patients were as follows: non-surgical treatment alone (n=45), emergency operation (n=50) and conversion to emergency operation due to failure of the initial conservative therapy (n=6). The present study analyzed the 45 patients managed with non-surgical treatment alone. The patients were divided, based on the median length of the hospital stay (nine day), into the shorter hospital stay and longer hospital stay groups. The risk factors and predictive factors for prolonged hospitalization were examined in the two groups. Results: Twenty-four patients were classified into the shorter hospital stay group and 21 were classified into the longer hospital stay group. A univariate analysis demonstrated that the body temperature on post-admission days 2 (P=0.012) and 3 (P=0.008), were significantly associated with the length of hospital stay. A multivariate logistic regression analysis using that the body temperature on post-admission day 3 tended to be associated with prolonged hospitalization (odds ratio=8.574, 95% confidence interval=0.973-75.525; P=0.053). The cut-off value of the body temperature on day 3, determined by an ROC curve analysis, was 37.05°C. This cut-off value showed 66.7% accuracy, 57.1% sensitivity and 75.0% specificity. Conclusion: The body temperature on post-admission day 3 might be a potential risk factor and predictive marker for prolonged hospitalization in patients who receive non-surgical treatment for appendiceal abscess.
VL  - 8
IS  - 1
ER  -

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