Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study

Antonio Crucitti, Laura Lorenzon, Gaetano Poillucci, Mauro Podda, Adolfo Pisanu, Lorenzo Mortola, Patrizia Dalla Caneva, Giulia Massa, Gianluca Costa, Riccardo Savastano, Nicola Cillara, F. Agresta, G. Alemanno, G. Anania, M. Antropoli, G. Argenio, J. Atzeni, N. Avenia, A. Azzinnaro, G. BaldazziG. Balducci, G. Barbera, G. Bellanova, C. Bergamini, L. Bersigotti, P. P. Bianchi, C. Bombardini, G. Borzellino, S. Bozzo, G. Brachini, G. M. Buonanno, T. Canini, S. Cardella, G. Carrara, D. Cassini, M. Castriconi, G. Ceccarelli, D. Celi, M. Ceresoli, M. Chiarugi, N. Cillara, F. Cimino, L. Cobuccio, G. Cocorullo, E. Colangelo, G. Costa, P. Dalla Caneva, M. De Luca, A. De Manzoni Garberini, C. De Nisco, M. De Prizio, A. De Sol, A. Dibella, T. Falcioni, N. Falco, C. Farina, E. Finotti, T. Fontana, G. Francioni, P. Fransvea, B. Frezza, G. Garulli, M. Genna, S. Giannessi, A. Gioffrè, A. Giordano, D. Gozzo, S. Grimaldi, G. Gulotta, V. Iacopini, T. Iarussi, E. Laterza, A. Leonardi, L. Lepre, G. Luridiana, A. Malagnino, G. Mar, P. Marini, R. Marzaioli, G. Massa, V. Mecarelli, A. Mingoli, G. Nigri, S. Occhionorelli, N. Paderno, G. M. Palini, D. Paradies, M. Paroli, F. Perrone, L. Petruzzelli, A. Pezzolla, D. Piazza, V. Piazza, M. Piccoli, A. Pisanu, M. Podda, G. Poillucci, R. Porfidia, G. Rossi, P. Ruscelli, A. Spagnoli, R. Sulis, D. Tartaglia, C. Tranà, A. Travaglino, P. Tomaiuolo, A. Valeri, G. Vasquez, M. Zago, E. Zanoni

Risultato della ricerca: Contributo in rivistaArticolo in rivista

4 Citazioni (Scopus)

Abstract

Background: A limited number of studies investigating perioperative risk factors associated with emergency appendectomy in elderly patients have been published to date. Whether older age may be associated with poorer outcomes following appendectomy is still a matter of debate. The primary aim of this study was to determine the predictors of postoperative morbidity following appendectomy in patients aged ≥ 65 years. Methods: Data regarding all elderly patients who underwent emergency appendectomy from January 2017 to June 2018 admitted 36 Italian surgical departments were prospectively collected and analyzed. Baseline demographics and perioperative variables were evaluated. Uni- and multivariate analyses adjusted for differences between groups were carried out to determine possible predictors of adverse outcomes after appendectomy. Results: Between January 2017 and June 2018, 135 patients aged ≥ 65 years with a diagnosis of AA met the study inclusion criteria. Twenty-six patients (19.3%) were diagnosed with some type of postoperative complication. Decreasing the preoperative hemoglobin level showed a statistically significant association with postoperative complications (OR 0.77, CI 0.61–0.97, P = 0.03). Preoperative creatinine level (P = 0.02, OR 2.04, CI 1.12–3.72), and open appendectomy (P = 0.03, OR 2.67, CI 1.11–6.38) were significantly associated with postoperative morbidity. After adjustment, the only independent predictor of postoperative morbidity was preoperative creatinine level (P = 0.04, OR 2.01, CI 1.05–3.89). Conclusions: In elderly patients with AA, perioperative risk assessment in the emergency setting must be as accurate as possible to identify modifiable risk factors that can be addressed before surgery, such as preoperative hemoglobin and creatinine levels.
Lingua originaleEnglish
pagine (da-a)N/A-N/A
RivistaEuropean Journal of Trauma and Emergency Surgery
DOI
Stato di pubblicazionePubblicato - 2019

Keywords

  • Acute appendicitis
  • Appendectomy
  • Elderly
  • Frail patients
  • Postoperative complications

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