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Archivos de Medicina (Manizales)

2021, Number 2

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Arch Med 2021; 21 (2)

Early factors associated with negative appendectomy

Ortiz-Vásquez JJ, Gómez-Aristizábal LI, Correa-Ángel MA, Díaz-Gómez E, Amarillo-Ortiz OA, Toro-Rivera JA, Ramírez-Nieto GL, Rojas-Gualdrón DF

Language: Spanish
References: 36
Page: 358-369
PDF size: 748.69 Kb.


ABSTRACT

Objective: to analyze predictive characteristics of negative appendectomy (NA) in a cohort of patients who underwent surgery during 2018 in a high complexity healthcare institution in the city of Medellín, Colombia. Materials and Methods: retrospective follow-up to a cohort of adult patients who underwent appendectomy. The rate of NA was estimated and the clinical, paraclinical and sociodemographic characteristics were described. The analysis of predictors of NA was carried out using the generalized linear model binomial family, logarithmic link. Observed and adjusted risk ratios (RR) are presented along with 95% confidence intervals (95% CI). For the multivariate model, the area under the receiver operator curve (ROC) was estimated. Results: the NA rate was 5.2%. Abdominal computed tomography (CT) was not requested in 48.9% of the cases, 4.1% of the patients had dysuria. Among the factors studied, dysuria, non-request for CT, age and leukocytosis were significantly associated with a higher risk of NA. Is worth noting that the adjusted risk of NA of the patients who presented with dysuria and those in which no CT was requested, was 30.3% (RR = 17.31; 95% CI 5.00 - 59.87). ROC was 0.834. Conclusions: patients who underwent surgery without CT and presented with dysuria, particularly the older ones, had the highest risk of NA. Considering these characteristics when defining the surgical management of patients with suspected acute appendicitis can help reduce NA.


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