Analysis of risk factors correlated with acute appendicitis with perforation

Yuan Chunyu; Yin Chunlin; Li He

doi:10.3969/j.issn.1003-5591.2024.06.004

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Analysis of risk factors correlated with acute appendicitis with perforation

更新时间：2026-11-05

- Analysis of risk factors correlated with acute appendicitis with perforation
- J Abdominal Surg Vol. 37, Issue 6, Pages: 413-417(2024)
- 作者机构：
  
  1.安徽医科大学第二附属医院急诊外科，安徽合肥 230601
  2.安徽医科大学微创介入研究中心，安徽合肥 230601
- 作者简介：
  
  Li He， Email： 422600897@qq.com.
- 基金信息：
- DOI：10.3969/j.issn.1003-5591.2024.06.004
  CLC： R656.8
- Received：03 May 2024，
  
  Published：22 December 2024
- 稿件说明：
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袁春雨,尹纯林,李贺.急性阑尾炎伴穿孔的相关危险因素分析[J].腹部外科,2024,37(06):413-417.

Yuan Chunyu,Yin Chunlin,Li He.Analysis of risk factors correlated with acute appendicitis with perforation[J].J Abdominal Surg,2024,37(06):413-417.
袁春雨,尹纯林,李贺.急性阑尾炎伴穿孔的相关危险因素分析[J].腹部外科,2024,37(06):413-417. DOI： 10.3969/j.issn.1003-5591.2024.06.004.

Yuan Chunyu,Yin Chunlin,Li He.Analysis of risk factors correlated with acute appendicitis with perforation[J].J Abdominal Surg,2024,37(06):413-417. DOI： 10.3969/j.issn.1003-5591.2024.06.004.

摘要

目的

探讨急性阑尾炎病人并发穿孔的相关危险因素。

方法

以安徽医科大学第二附属医院2023年1月至6月期间收治的212例急性阑尾炎病人为研究对象，结合手术中观察阑尾有无穿孔和术后送检阑尾病理结果，分成急性阑尾炎未穿孔组（

=169）和急性阑尾炎伴穿孔组（

=43）。收集病人入院时一般资料（年龄、性别、院前发病持续时间等）、血液检测指标（血常规、总胆红素和D-二聚体等相关指标）和影像学指标（阑尾是否含有粪石和是否合并腹腔积液），进行两组间比较，对有意义的指标进行多因素logistic回归分析和绘制受试者操作特征曲线。

结果

212例急性阑尾炎病人中穿孔43例，占20.3%，对各指标进行单因素和多因素logistic回归分析得出症状持续时间、体温≥38 ℃、阑尾是否有粪石、是否合并腹腔积液以及血C-反应蛋白（CRP）水平是急性阑尾炎伴穿孔的独立危险因素（均

＜0.05），并进一步绘制受试者操作特征曲线显示，单指标预测中症状持续时间、是否合并腹腔积液和血CRP水平曲线下面积依次为0.827、0.853和0.810（均

＜0.05）。各指标联合预测阑尾炎穿孔风险时曲线下面积为0.962，敏感度为0.884，特异度为0.893。

结论

急性阑尾炎病人发病时症状持续时间、体温≥38 ℃、阑尾是否含有粪石、是否合并腹腔积液及入院时血CRP水平是急性阑尾炎伴穿孔病人的独立危险因素，各指标联合预测阑尾穿孔风险价值更高。

Abstract

Objective

To explore the risk factors of acute appendicitis （AA） with perforation.

Methods

From January to June 2023， a total of 212 hospitalized AA patients were selected as study subjects. According to the observation o

f appendix and pathological results， they were assigned into two groups of non-perforated （

=169） and perforated （

=43）. Demographic profiles （e.g. gender， age

duration of onset）， blood test parameters （e.g. blood routine， total bilirubin

D-dimer） and imaging findings （whether or not fecalith within appendix and ascites in abdominal cavity） were compared between two groups. The influencing factors of perforated AA were examined by multivariate Logistic regression analysis and receiver operating characteristic （ROC） curve.

Results

There were 43 cases of perforated AA with a perforation rate of 20.3%. Longer symptomatic duration， fever （axillary temperature ≥38 ℃）， appendiceal fecalith on imaging， ascites on imaging and elevated level of C-reactive protein （CRP） were independent risk factors for perforated AA were examined by single factor and multiple factor Logistic regression （

0.05）. The area under the ROC curve of longer symptomatic duration， ascites and CRP level were 0.827， 0.853 and 0.810 （

0.05）. When all parameters were combined for prediction， AUC was 0.962 with a sensitivity of 0.884 and a specificity of 0.893.

Conclusion

Longer symptomatic duration， fever （axillary temperature ≥38 ℃）， appendiceal fecalith on imaging， ascites on imaging and elevated CRP level are independent risk factors for perforated AA. There is a higher value when all parameters are combined for assessments.

关键词

Keywords

references

沈中梅，袁潇 . 急性坏疽性阑尾炎穿孔的CT诊断［J］. 影像研究与医学应用， 2022 ， 6 （ 6 ）： 34 - 36 . DOI： 10.3969/j.issn.2096-3807.2022.06.012 http://dx.doi.org/10.3969/j.issn.2096-3807.2022.06.012 .

Krzyzak M ， Mulrooney SM . Acute appendicitis review：background，epidemiology，diagnosis，and treatment ［J］. Cureus ， 2020 ， 12 （ 6 ）： e8562 . DOI： 10.7759/cureus.8562 http://dx.doi.org/10.7759/cureus.8562 .

Wickramasinghe DP ， Xavier C ， Samarasekera DN . The worldwide epidemiology of acute appendicitis：an analysis of the global health data exchange dataset ［J］. World J Surg ， 2021 ， 45 （ 7 ）： 1999 - 2008 . DOI： 10.1007/s00268-021-06077-5 http://dx.doi.org/10.1007/s00268-021-06077-5 .

McCutcheon BA ， Chang DC ， Marcus LP ， et al . Long-term outcomes of patients with nonsurgically managed uncomplicated appendicitis ［J］. J Am Coll Surg ， 2014 ， 218 （ 5 ）： 905 - 913 . DOI： 10.1016/j.jamcollsurg.2014.01.003 http://dx.doi.org/10.1016/j.jamcollsurg.2014.01.003 .

闫云峰 . 急性阑尾炎严重程度的影响因素分析［J］. 中国药物与临床， 2021 ， 21 （ 3 ）： 405 - 406 . DOI： 10.11655/zgywylc2021.03.014 http://dx.doi.org/10.11655/zgywylc2021.03.014 .

Emektar E ， Dağar S ， Karaatlı RH ， et al . Determination of factors associated with perforation in patients with geriatric acute appendicitis ［J］. Turk J Trauma Emerg Surg ， 2022 ， 28 （ 1 ）： 33 - 38 . DOI： 10.14744/tjtes.2020.25741 http://dx.doi.org/10.14744/tjtes.2020.25741 .

Patmano M ， Çetin DA ， Gümüş T . Laboratory markers used in the prediction of perforation in acute appendicitis ［J］. Turk J Trauma Emerg Surg ， 2022 ， 28 （ 7 ）： 960 - 966 . DOI： 10.14744/tjtes.2021.83364 http://dx.doi.org/10.14744/tjtes.2021.83364 .

Sajjad MN ， Naumeri F ， Hina S . Non-operative treatment versus appendectomy for acute uncomplicated appendicitis：a randomized controlled trial ［J］. Pak J Med Sci ， 2021 ， 37 （ 5 ）： 1276 - 1281 . DOI： 10.12669/pjms.37.5.4016 http://dx.doi.org/10.12669/pjms.37.5.4016 .

张文良，汪圣毅，雷伟 . 急性阑尾炎患者穿孔的发病率及其危险因素研究［J］. 中国全科医学， 2015 ， 18 （ 23 ）： 2792 - 2795 . DOI： 10.3969/j.issn.1007-9572.2015.23.011 http://dx.doi.org/10.3969/j.issn.1007-9572.2015.23.011 .

Miyauchi H ， Okata Y ， Hatakeyama T ， et al . Analysis of predictive factors for perforated appendicitis in children ［J］. Pediatr Int ， 2020 ， 62 （ 6 ）： 711 - 715 . DOI： 10.1111/ped.14148 http://dx.doi.org/10.1111/ped.14148 .

Westfall KM ， Charles AG . Risk of perforation in the era of nonemergent management for acute appendicitis ［J］. Am Surg ， 2019 ， 85 （ 11 ）： 1209 - 1212 .

Busch M ， Gutzwiller FS ， Aellig S ， et al . In-hospital delay increases the risk of perforation in adults with appendicitis ［J］. World J Surg ， 2011 ， 35 （ 7 ）： 1626 - 1633 . DOI： 10.1007/s00268-011-1101-z http://dx.doi.org/10.1007/s00268-011-1101-z .

Kang CB ， Li XW ， Hou SY ， et al . Preoperatively predicting the pathological types of acute appendicitis using machine learning based on peripheral blood biomarkers and clinical features：a retrospective study ［J］. Ann Transl Med ， 2021 ， 9 （ 10 ）： 835 . DOI： 10.21037/atm-20-7883 http://dx.doi.org/10.21037/atm-20-7883 .

房誉轩 . D二聚体和白细胞计数、C-反应蛋白、降钙素原在急性阑尾炎患者中的诊断价值［J］. 血栓与止血学， 2021 ， 27 （ 5 ）： 841 - 842 . DOI： 10.3969/j.issn.1009-6213.2021.05.050 http://dx.doi.org/10.3969/j.issn.1009-6213.2021.05.050 .

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