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Kim DY, Nassiri N, de Virgilio C, et al. Association Between Hyponatremia and Complicated Appendicitis. JAMA Surg. 2015;150(9):911–912. doi:10.1001/jamasurg.2015.1258
Complicated appendicitis is associated with worse outcomes among patients with acute appendicitis.1 Preoperative identification of patients with a perforated or gangrenous appendicitis may have important clinical implications regarding the timing of surgery and the suitability for nonoperative management strategies. The objective of this study was to identify clinical variables associated with the presence of complicated appendicitis.
Following institutional review board approval from the Los Angeles Biomedical Research Institute in Torrance, California, we conducted a retrospective analysis of adult patients (>18 years of age) who underwent an appendectomy for acute appendicitis at Harbor-UCLA and Olive View–UCLA Medical Centers over a 3.5-year period. Exclusion criteria included pregnancy and a pathologic diagnosis of chronic appendicitis or appendiceal neoplasm. Complicated appendicitis was defined as the intraoperative finding of a perforated or gangrenous appendix. Variables analyzed included findings from history taking and a physical examination, admission laboratory values, and operative details. Statistically significant variables were entered into a multiple logistic regression model to identify independent predictors of complicated appendicitis. The study participants did not provide informed consent because all study data were deidentified.
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