Plasma Sodium and Age Are Important Markers of Risk of Perforation in Acute Appendicitis

Excerpt

Acute appendicitis (AA) is the most common cause for emergency abdominal surgery worldwide.1 Although the risk of perforation is probably not increased by delays to surgery in stable patients,2 perforation is associated with an increase in postoperative complications including abscess formation, paralytic ileus, and in rare cases even death.1 Finding preoperative markers of perforation is important in allocating resources to those with perforated disease and in understanding the disease process. A negative correlation with strong negative predictive value between plasma sodium concentration and the rate of perforation in acute appendicitis and diverticulitis in patients over 50 years of age has been reported.3 Recent work has confirmed that even mild hyponatremia in patients presenting with AA is correlated with complicated appendicitis in adults.3,4 A recent study5 on children with appendicitis found a pronounced correlation (odds ratio 32) between hyponatremia at time of admission and the rate of perforation. …