Highlights
- •29% of patients had recurrent appendicitis within 6 months.
- •Median time to recurrent appendicitis was 17 days.
- •A competing-risk analysis was used to find predictors of recurrent appendicitis.
- •Appendicolith was the only factor associated with recurrent appendicitis.
- •By 6 months, 67% of patients with an appendicolith had undergone appendectomy.
Abstract
Background
The objective of this study is to identify predictors for recurrent appendicitis in
patients with appendicitis previously treated nonoperatively.
Methods
This is a prospective cohort study of all adult patients with appendicitis treated
at a tertiary care hospital. Patient demographics, radiographic information, management,
and clinical outcomes were recorded. The primary outcome was recurrent appendicitis
within 6 months after discharge from the index admission. Given the competing risk
of interval appendectomy, a time-to-event competing-risk analysis was performed.
Results
Of the 699 patients presenting with appendicitis, 74 were treated nonoperatively (35
[47%] were women; median [IQR] age, 48 [33,64] years), and 21 patients (29%) had recurrent
appendicitis. On univariate and multivariate analysis, presence of an appendicolith
on imaging was the only factor associated with a higher risk of recurrent appendicitis
(p = 0.02).
Conclusions
The presence of appendicolith was associated with an increased risk of developing
recurrent appendicitis within 6 months.
Graphical abstract
Graphical Abstract
Keywords
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Article info
Publication history
Published online: March 10, 2023
Accepted:
March 6,
2023
Received in revised form:
February 23,
2023
Received:
October 1,
2022
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
