caa a22 4500 60549312X CHVBK 20210128100519.0 cr unu---uuuuu 210128e20151001xx s 000 0 eng 10.1007/s00261-015-0478-9 doi (NATIONALLICENCE)springer-10.1007/s00261-015-0478-9 Pre-operative CT predictors associated with 30-day adverse events in patients with appendiceal inflammatory masses who underwent immediate appendectomies [Elektronische Daten] [Myung Kim, Mi Kim, Dong Kim, Hae Park, Hee-Jin Park, Hyun Hong, Heon-Ju Kwon] Purpose: To retrospectively evaluate pre-operative CT predictors that are associated with 30-day adverse events in patients who underwent immediate appendectomies for appendiceal inflammatory masses. Methods: This retrospective study was approved by our institutional review board, and the requirement for informed consent was waived. One hundred forty-four consecutive patients who underwent immediate appendectomies and were diagnosed with appendiceal inflammatory masses by pre-operative CT from January 2005 to December 2013 at a tertiary hospital were included. The main outcome measure was 30-day adverse events. Patient demographics and data for inflammatory markers including leukocyte counts, segmented neutrophils, and C-reactive protein levels were collected by a single radiologist. Pre- and post-operative CT findings were evaluated for features of appendiceal inflammatory masses, associated findings, and post-operative adverse events by two radiologists in a blinded fashion with consensus to assess surgical and pathologic results, post-operative outcomes, and original CT interpretations. Appendiceal inflammatory masses were defined as complicated appendicitis with a phlegmon or an abscess that was identified on pre-operative CT exam. Factors associated with 30-day adverse events were assessed using logistic regression analysis. Results: A total of 22 (15%) of the 144 patients (mean age [±SD] 44.6±22.0years, range 3-97years) experienced 30-day adverse events: ten intra-abdominal abscesses, three wound infections, two cases of peritonitis, two small bowel obstructions, two intra-abdominal abscesses with peritonitis, one intra-abdominal abscess with wound infection, one intra-abdominal abscess with small bowel obstruction, and one case of peritonitis with small bowel obstruction. In univariate analysis, the presence of appendicolith (odds ratio [OR] 2.49, p=0.048) and high-grade obstruction (OR 3.79; p=0.01) were associated with adverse events. High-grade obstruction (adjusted OR 3.05; p=0.04) was the only independent pre-operative predictor associated with 30-day adverse events in patients with appendiceal inflammatory masses. Conclusions: High-grade obstruction was an independent pre-operative CT predictor associated with 30-day adverse events in patients who underwent immediate appendectomies for appendiceal inflammatory masses. Springer Science+Business Media New York, 2015 Appendicitis nationallicence Appendiceal inflammatory mass nationallicence Complication nationallicence Computed tomography nationallicence Kim Myung Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut Kim Mi Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut Kim Dong Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut Park Hae Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut Park Hee-Jin Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut Hong Hyun Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut Kwon Heon-Ju Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2263-2271 0942-8925 40:7<2263 2015 40 261 https://doi.org/10.1007/s00261-015-0478-9 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s00261-015-0478-9 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Kim Myung Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut NATIONALLICENCE 700 1- Kim Mi Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut NATIONALLICENCE 700 1- Kim Dong Department of Pathology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut NATIONALLICENCE 700 1- Park Hae Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut NATIONALLICENCE 700 1- Park Hee-Jin Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut NATIONALLICENCE 700 1- Hong Hyun Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut NATIONALLICENCE 700 1- Kwon Heon-Ju Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyong dong, Jongro-gu, 110-746, Seoul, Korea aut NATIONALLICENCE 773 0- Abdominal Imaging Springer US; http://www.springer-ny.com 40/7(2015-10-01), 2263-2271 0942-8925 40:7<2263 2015 40 261