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Clinical, Laboratory and Radiographic Features Associated With Prolonged Hospitalization in Children With Complicated Appendicitis

OBJECTIVE: In children with appendicitis, rupture of the appendix is associated with a significant increase in morbidity. We sought to characterize the spectrum of illness in children with complicated appendicitis and to define those factors associated with a longer hospital stay. STUDY DESIGN: We c...

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Autores principales: Bhattacharya, Jyotsna, Silver, Ellen J., Blumfield, Einat, Jan, Dominique M., Herold, Betsy C., Goldman, David L.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019112/
https://www.ncbi.nlm.nih.gov/pubmed/35463908
http://dx.doi.org/10.3389/fped.2022.828748
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author Bhattacharya, Jyotsna
Silver, Ellen J.
Blumfield, Einat
Jan, Dominique M.
Herold, Betsy C.
Goldman, David L.
author_facet Bhattacharya, Jyotsna
Silver, Ellen J.
Blumfield, Einat
Jan, Dominique M.
Herold, Betsy C.
Goldman, David L.
author_sort Bhattacharya, Jyotsna
collection PubMed
description OBJECTIVE: In children with appendicitis, rupture of the appendix is associated with a significant increase in morbidity. We sought to characterize the spectrum of illness in children with complicated appendicitis and to define those factors associated with a longer hospital stay. STUDY DESIGN: We conducted a retrospective review of 132 children, 18 years of age or younger at a large urban teaching hospital in the Bronx, NY between October 2015 and April 2018 with an intraoperative diagnosis of perforated appendix. Clinical, laboratory and radiologic findings were reviewed, and the primary study outcome was length of stay (LOS) dichotomized at the median, which was 7 days. Statistical analyses were done to characterize morbidity and define variables predictive of longer stay. RESULTS: Children in the longer LOS group experienced significantly more morbidity, including ICU stay, ileus, and need for multiple drainage procedures. A longer duration of symptoms prior to presentation was associated with a longer stay. Multivariable logistic regression analysis indicated that the presence of abscess and presence of free fluid in the right upper quadrant (RUQ FF) on initial imaging and C-reactive protein (CRP) level >12 at admission, were independently associated with a longer stay. CONCLUSION: There is considerable variation in the morbidity of complicated appendicitis. The association between longer stay and the findings of abscess and RUQ FF on initial imaging along with an elevated CRP may provide a useful tool in identifying those children at risk for worse outcomes.
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spelling pubmed-90191122022-04-21 Clinical, Laboratory and Radiographic Features Associated With Prolonged Hospitalization in Children With Complicated Appendicitis Bhattacharya, Jyotsna Silver, Ellen J. Blumfield, Einat Jan, Dominique M. Herold, Betsy C. Goldman, David L. Front Pediatr Pediatrics OBJECTIVE: In children with appendicitis, rupture of the appendix is associated with a significant increase in morbidity. We sought to characterize the spectrum of illness in children with complicated appendicitis and to define those factors associated with a longer hospital stay. STUDY DESIGN: We conducted a retrospective review of 132 children, 18 years of age or younger at a large urban teaching hospital in the Bronx, NY between October 2015 and April 2018 with an intraoperative diagnosis of perforated appendix. Clinical, laboratory and radiologic findings were reviewed, and the primary study outcome was length of stay (LOS) dichotomized at the median, which was 7 days. Statistical analyses were done to characterize morbidity and define variables predictive of longer stay. RESULTS: Children in the longer LOS group experienced significantly more morbidity, including ICU stay, ileus, and need for multiple drainage procedures. A longer duration of symptoms prior to presentation was associated with a longer stay. Multivariable logistic regression analysis indicated that the presence of abscess and presence of free fluid in the right upper quadrant (RUQ FF) on initial imaging and C-reactive protein (CRP) level >12 at admission, were independently associated with a longer stay. CONCLUSION: There is considerable variation in the morbidity of complicated appendicitis. The association between longer stay and the findings of abscess and RUQ FF on initial imaging along with an elevated CRP may provide a useful tool in identifying those children at risk for worse outcomes. Frontiers Media S.A. 2022-04-06 /pmc/articles/PMC9019112/ /pubmed/35463908 http://dx.doi.org/10.3389/fped.2022.828748 Text en Copyright © 2022 Bhattacharya, Silver, Blumfield, Jan, Herold and Goldman. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Pediatrics
Bhattacharya, Jyotsna
Silver, Ellen J.
Blumfield, Einat
Jan, Dominique M.
Herold, Betsy C.
Goldman, David L.
Clinical, Laboratory and Radiographic Features Associated With Prolonged Hospitalization in Children With Complicated Appendicitis
title Clinical, Laboratory and Radiographic Features Associated With Prolonged Hospitalization in Children With Complicated Appendicitis
title_full Clinical, Laboratory and Radiographic Features Associated With Prolonged Hospitalization in Children With Complicated Appendicitis
title_fullStr Clinical, Laboratory and Radiographic Features Associated With Prolonged Hospitalization in Children With Complicated Appendicitis
title_full_unstemmed Clinical, Laboratory and Radiographic Features Associated With Prolonged Hospitalization in Children With Complicated Appendicitis
title_short Clinical, Laboratory and Radiographic Features Associated With Prolonged Hospitalization in Children With Complicated Appendicitis
title_sort clinical, laboratory and radiographic features associated with prolonged hospitalization in children with complicated appendicitis
topic Pediatrics
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9019112/
https://www.ncbi.nlm.nih.gov/pubmed/35463908
http://dx.doi.org/10.3389/fped.2022.828748
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