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European Journal of Trauma and Emergency Surgery

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01-12-2021 | Appendicitis | Original Article

Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study

Authors: Gaetano Poillucci, Mauro Podda, Adolfo Pisanu, Lorenzo Mortola, Patrizia Dalla Caneva, Giulia Massa, Gianluca Costa, Riccardo Savastano, Nicola Cillara, On behalf of the ERASO (Elderly Risk Assessment And Surgical Outcome) Collaborative Study Group

Published in: European Journal of Trauma and Emergency Surgery | Issue 6/2021

Abstract

Background

A limited number of studies investigating perioperative risk factors associated with emergency appendectomy in elderly patients have been published to date. Whether older age may be associated with poorer outcomes following appendectomy is still a matter of debate. The primary aim of this study was to determine the predictors of postoperative morbidity following appendectomy in patients aged ≥ 65 years.

Methods

Data regarding all elderly patients who underwent emergency appendectomy from January 2017 to June 2018 admitted 36 Italian surgical departments were prospectively collected and analyzed. Baseline demographics and perioperative variables were evaluated. Uni- and multivariate analyses adjusted for differences between groups were carried out to determine possible predictors of adverse outcomes after appendectomy.

Results

Between January 2017 and June 2018, 135 patients aged ≥ 65 years with a diagnosis of AA met the study inclusion criteria. Twenty-six patients (19.3%) were diagnosed with some type of postoperative complication. Decreasing the preoperative hemoglobin level showed a statistically significant association with postoperative complications (OR 0.77, CI 0.61–0.97, P = 0.03). Preoperative creatinine level (P = 0.02, OR 2.04, CI 1.12–3.72), and open appendectomy (P = 0.03, OR 2.67, CI 1.11–6.38) were significantly associated with postoperative morbidity. After adjustment, the only independent predictor of postoperative morbidity was preoperative creatinine level (P = 0.04, OR 2.01, CI 1.05–3.89).

Conclusions

In elderly patients with AA, perioperative risk assessment in the emergency setting must be as accurate as possible to identify modifiable risk factors that can be addressed before surgery, such as preoperative hemoglobin and creatinine levels.

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Title: Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study
Authors: Gaetano Poillucci
Mauro Podda
Adolfo Pisanu
Lorenzo Mortola
Patrizia Dalla Caneva
Giulia Massa
Gianluca Costa
Riccardo Savastano
Nicola Cillara
On behalf of the ERASO (Elderly Risk Assessment And Surgical Outcome) Collaborative Study Group
Publication date: 01-12-2021
Publisher: Springer Berlin Heidelberg
Keywords: Appendicitis
Appendicitis
Appendectomy
Published in: European Journal of Trauma and Emergency Surgery / Issue 6/2021
Print ISSN: 1863-9933
Electronic ISSN: 1863-9941
DOI: https://doi.org/10.1007/s00068-019-01186-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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