Risks Associated with Surgical Treatment for Appendicitis in Hematologic Patients

SIMPLE SUMMARY: Appendicitis is a common condition necessitating emergency surgery. Individuals with hematologic disorders often have abnormalities in blood counts, which can act as risk factors for surgical complications. This study explores surgical risks in appendicitis patients with hematologic disorders, using a retrospective analysis from January 2000 to June 2021. Among the 131 identified patients, 89 were studied; 75 underwent surgery, while 14 received non-surgical treatments. No significant relationship was found between clinical characteristics, hematologic disease risk, severity of appendicitis, and surgical complications. Improved preoperative absolute neutrophil count and platelet counts were higher than those of initial findings in patients without surgical complications. Lower preoperative absolute neutrophil counts and platelet counts were correlated with extended hospital stays. The findings suggest that for hematologic patients with appendicitis, meticulous preoperative laboratory evaluations followed by minimally invasive appendectomy could be a safer approach without increasing the risk of severe complications compared to non-surgical management. ABSTRACT: Appendicitis is a prevalent surgical emergency. Although appendectomy has traditionally been the go-to treatment, recent studies suggest antibiotics can be equally effective for uncomplicated cases. However, evidence is scant regarding patients with hematologic disorders. This study delves into the surgical risks tied to appendicitis in patients with underlying hematologic conditions. A retrospective analysis was carried out on patients diagnosed with appendicitis and hematologic disorders from January 2000 to June 2021. Patients were pinpointed using ICD-10 diagnostic codes, and surgical procedures were identified based on the hospital’s surgical fee codes. Hematologic conditions were sorted into risk levels, and patient treatments were scrutinized. Among the 131 initially identified patients, 89 were included in the study. Out of these, 75 underwent surgical procedures, while 14 received non-surgical treatments. The surgical group displayed better preoperative laboratory outcomes. Clinical characteristics, hematologic disease risk, and severity of appendicitis appeared not to be related to surgical complications. Patients without surgical complications showed improvement in preoperative absolute neutrophil count (ANC) and platelet counts. Lower preoperative ANCs and platelet counts were associated with extended hospital stays. For patients with hematologic disorders diagnosed with appendicitis, thorough preoperative laboratory evaluations followed by minimally invasive appendectomy appear to be a safe route without heightening the risk of severe complications compared to non-surgical management.