Operative Findings Are a Better Predictor of Resource Utilization in Pediatric Appendicitis

Journal of Pediatric Surgery
Sandra M FarachNicole M Chandler

Abstract

Post-operative management following appendectomy is dependent upon intraoperative assessment. We determined concordance between surgical and histopathologic diagnosis to better predict resource utilization in pediatric patients undergoing appendectomy. A retrospective analysis of 326 patients with operative appendicitis from July 2012 to July 2013 was performed. Based on operative findings, patients were classified as simple appendicitis (SA) or complex appendicitis (CA). The SA group included 194 (59.5%) patients while the CA group included 132 (40.5%) patients. There were significant differences in WBC, CRP, operative time, length of stay, and 30-day complications. Seventy percent of patients with intra-operative findings of SA were found to have complex pathology while 10.6% with intra-operative findings of CA were found to have simple pathology. There is poor agreement between intra-operative findings and histopathologic findings (κ=0.173). Although 70% of patients with intra-operative findings of SA were labeled as complex pathology, 86% followed a fast track protocol (same day discharge) with a low complication rate (1.7%). Pathology findings that overestimate the severity of disease correlate poorly with the post-operati...Continue Reading

References

Apr 5, 2008·International Journal of Surgical Pathology·John K RobertsJanek Dmitrewski
Dec 2, 2008·Journal of Pediatric Surgery·Shawn D St PeterDaniel J Ostlie

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Citations

Jul 13, 2016·Pediatric Annals·Grace Zee Mak, Deborah S Loeff
Oct 10, 2019·Diseases of the Colon and Rectum·Elisabeth M L de WijkersloothUNKNOWN Snapshot Appendicitis Study Group
Sep 1, 2020·Journal of Interferon & Cytokine Research : the Official Journal of the International Society for Interferon and Cytokine Research·Wen LiuJinWei Qiang
Apr 17, 2020·World Journal of Emergency Surgery : WJES·Salomone Di SaverioFausto Catena
Apr 18, 2018·The British Journal of Surgery·A L van den BoomB P L Wijnhoven
May 18, 2019·Journal of Pediatric Surgery·Yangyang R YuBindi J Naik-Mathuria

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