Risk factor leading to complicated appendicitis: pelvic position of the appendix

Koh, Hyunseung; Yang, Heebum; Cho, Kwanghyun; Jung, Yoon Young; Chang, Yeon Soo; Kim, Dong Hee; Kim, Min Sung

J Korean Soc Emerg Med > Volume 32(2); 2021 > Article

Original Article

Journal of The Korean Society of Emergency Medicine 2021;32(2): 134-142.

Risk factor leading to complicated appendicitis: pelvic position of the appendix

¹Department of Emergency Medicine, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
²Department of Radiology, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea
³Department of Surgery, Nowon Eulji Medical Center, Eulji University College of Medicine, Seoul, Korea

Correspondence

Min Sung Kim ,Tel: 02-970-8243, Fax: 02-313-8227, Email: drkms77@eulji.ac.kr,

Received: June 15, 2020; Revised: August 28, 2020 Accepted: September 11, 2020. Published online: April 30, 2021.

ABSTRACT

Objective:
Several factors contribute to the progression of complicated appendicitis (CA) in patients diagnosed with acute appendicitis. The goal of this study was to investigate whether the pelvic location of an appendix may be a new prehospital risk factor associated with CA.
Method:
The study retrospectively reviewed 375 patients who underwent surgery for appendicitis from January 2013 to December 2013. Patients were divided into two groups: patients diagnosed with uncomplicated appendicitis (UA) and patients with CA. Demographics, clinical and laboratory findings, duration of symptoms, and the location of the appendix were evaluated. Univariate and multivariate statistical analyses identified risk factors leading to CA.
Results:
Of the 375 patients, 46 (12.3%) had CA. The univariate analysis confirmed that the patients diagnosed with CA had a higher body temperature (BT), longer duration of symptoms (DOS), and complained of left lower quadrant abdominal (LLQ) pain more frequently. Furthermore, compared to the UA group, the appendix was more frequently located in the pelvic region in the CA group. Multivariate analysis confirmed that BT >37.5°C (odds ratio [OR], 3.29; 95% confidence interval [CI], 1.64-6.61; P<0.01), LLQ pain (OR, 2.78; 95% CI, 1.16-6.69; P=0.02), DOS ≥48 hours (OR, 3.87; 95% CI, 1.94-7.71; P<0.01), and the pelvic location of appendix (OR, 3.18; 95% CI, 1.49-6.75; P<0.01) were risk factors for CA.
Conclusion:
The pelvic location of an appendix may be a new prehospital risk factor associated with CA.

Key words: Appendix; Appendicitis; Risk factors; Pelvic location