TY - JOUR
T1 - Risk of emergency surgery for complicated appendicitis
T2 - Japanese nationwide study
AU - Yamada, Takeshi
AU - Endo, Hideki
AU - Hasegawa, Hiroshi
AU - Kimura, Toshimoto
AU - Kakeji, Yoshihiro
AU - Koda, Keiji
AU - Ishida, Hideyuki
AU - Sakamoto, Kazuhiro
AU - Hirata, Keiji
AU - Yamamoto, Hiroyuki
AU - Miyata, Hiroaki
AU - Matsuda, Akihisa
AU - Yoshida, Hiroshi
AU - Kitagawa, Yuko
N1 - Funding Information:
The authors thank all the data managers and hospitals participating in the NCD project for their great effort in entering the data. This study was supported by a grant from the Japanese Society for Abdominal Emergency Medicine. We thank Nancy Schatken, BS, MT(ASCP), from Edanz Group ( https://en‐author‐services.edanzgroup.com/ ), for editing a draft of this manuscript.
Funding Information:
Hideki Endo, Hiroyuki Yamamoto, and Hiroaki Miyata are affiliated with the Department of Healthcare Quality Assessment at the University of Tokyo. The department is a social collaboration department supported by grants from the National Clinical Database, Johnson & Johnson KK, and Nipro Corporation.
Funding Information:
The authors thank all the data managers and hospitals participating in the NCD project for their great effort in entering the data. This study was supported by a grant from the Japanese Society for Abdominal Emergency Medicine. We thank Nancy Schatken, BS, MT(ASCP), from Edanz Group (https://en-author-services.edanzgroup.com/), for editing a draft of this manuscript.
Publisher Copyright:
© 2020 The Authors. Annals of Gastroenterological Surgery published by John Wiley & Sons Australia, Ltd on behalf of The Japanese Society of Gastroenterological Surgery
PY - 2021/3
Y1 - 2021/3
N2 - Aim: Appendicitis is divided into two categories: complicated appendicitis (CA) and uncomplicated appendicitis (UA). In pediatric patients with CA, the use of interval appendectomy (IA), which is non-operative management followed by elective surgery, has decreased the number of postoperative complications. Before discussing the merit of IA for adult patients, we need to clarify whether the frequency and seriousness of the complication rate after emergency surgery is higher for CA than for UA. Methods: This retrospective cohort study included adult patients who underwent appendectomy and who were registered in the National Clinical Database (NCD) from 2014 to 2016. Patients with CA who underwent emergency appendectomy comprised the CA group. Patients with UA comprised the UA group. Patients with chronic or recurrent appendicitis who underwent elective appendectomy comprised the elective appendectomy (EA) group. Primary outcomes were all morbidity, serious morbidity, and mortality within 30 days after appendectomy. Results: We included 109 256 patients in the study: 14 798 CA, 86 876 UA, and 7582 EA patients. Compared with the UA group, the rates of all morbidity, serious morbidity, and mortality were significantly higher in the CA group. All morbidity, serious morbidity, and mortality rates were significantly lower in the EA group than in the other two groups. Conclusions: We confirmed that emergency surgery for CA places the patient at relatively higher risk. We also showed that the risk associated with EA is significantly lower than that for the other methods.
AB - Aim: Appendicitis is divided into two categories: complicated appendicitis (CA) and uncomplicated appendicitis (UA). In pediatric patients with CA, the use of interval appendectomy (IA), which is non-operative management followed by elective surgery, has decreased the number of postoperative complications. Before discussing the merit of IA for adult patients, we need to clarify whether the frequency and seriousness of the complication rate after emergency surgery is higher for CA than for UA. Methods: This retrospective cohort study included adult patients who underwent appendectomy and who were registered in the National Clinical Database (NCD) from 2014 to 2016. Patients with CA who underwent emergency appendectomy comprised the CA group. Patients with UA comprised the UA group. Patients with chronic or recurrent appendicitis who underwent elective appendectomy comprised the elective appendectomy (EA) group. Primary outcomes were all morbidity, serious morbidity, and mortality within 30 days after appendectomy. Results: We included 109 256 patients in the study: 14 798 CA, 86 876 UA, and 7582 EA patients. Compared with the UA group, the rates of all morbidity, serious morbidity, and mortality were significantly higher in the CA group. All morbidity, serious morbidity, and mortality rates were significantly lower in the EA group than in the other two groups. Conclusions: We confirmed that emergency surgery for CA places the patient at relatively higher risk. We also showed that the risk associated with EA is significantly lower than that for the other methods.
KW - appendicitis
KW - complicated appendicitis
KW - morbidity
KW - mortality
KW - uncomplicated appendicitis
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U2 - 10.1002/ags3.12408
DO - 10.1002/ags3.12408
M3 - Article
AN - SCOPUS:85096688334
SN - 2475-0328
VL - 5
SP - 236
EP - 242
JO - Annals of Gastroenterological Surgery
JF - Annals of Gastroenterological Surgery
IS - 2
ER -