J Korean Soc Emerg Med.  2018 Dec;29(6):671-678. 10.0000/jksem.2018.29.6.671.

The comparative study of predictive factors for prolonged length of stays that adult patients with acute appendicitis in emergency department

• Jang YJ
• Kim SY
• Hong DY
• Baek KJ
• Park SO
• Kim JW
• Kim JY
• Lee KR

• KMID: 2432058
• DOI: http://doi.org/10.0000/jksem.2018.29.6.671

Abstract

OBJECTIVE
This study examined the predictive factors for prolonged length of stays of adult patients with acute appendicitis (AA) in an emergency department (ED).
METHODS
This was a retrospectively clinical study including patients in an ED. All patients were diagnosed from the clinical symptoms and a typical physical examination, and had undergone a computed tomography (CT) evaluation on the ED visiting date. All data were collected from the electrical medical records. The clinical parameters analyzed were the laboratory data, including the white blood cell count with differential values, C-reactive protein (CRP) level, initial vital signs, duration of admission, coexisting perforation of the appendix in the CT findings. The relationship between the clinical parameters and length of stay was assessed.
RESULTS
A total of 547 patients with AA were enrolled in this study. Among them, there were 270 male patients with a mean age of 40.7±15.8 years. The baseline characteristics, initial clinical features, laboratory, and imaging studies results of 129 patients in the prolonged length of stay (pLOS) group, and 418 patients of the non-pLOS group in AA were compared. Multivariable logistic regression analysis revealed the predictive factors related to pLOS in AA to be as follows: age 40 years or older, body temperature over 37.3℃, CRP level greater than 5.0 mg/dL, and evidence of perforation in CT findings (P < 0.001).
CONCLUSION
If we check age, fever, CRP level and find evidence of perforation, it might be helpful for predicting the increasing period of length of hospital stay for patients with AA in ED.

Keyword

Appendicitis; Length of stay; Hospitalization; Diagnosis-related groups

MeSH Terms

Adult*
Appendicitis*
Appendix
Body Temperature
C-Reactive Protein
Clinical Study
Diagnosis-Related Groups
Emergencies*
Emergency Service, Hospital*
Fever
Hospitalization
Humans
Length of Stay
Leukocyte Count
Logistic Models
Male
Medical Records
Physical Examination
Retrospective Studies
Vital Signs
C-Reactive Protein