ArticleAnnals of surgical treatment and research2017
Meaningful standard of reference for appendiceal perforation: pathology, surgery, or both?
Article in Annals of surgical treatment and research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed.
- Appendiceal Visualization on 2-mSv CT vs. Conventional-Dose CT in Adolescents and Young Adults with Suspected Appendicitis: An Analysis of Large Pragmatic Randomized Trial Data.Korean journal of radiology · 2022Trial
- Trial
- Appendicitis inflammatory response versus pediatric appendicitis score for grading disease severity in children.Scientific reports · 2026Observational
- Low-Dose Abdominal CT for Evaluating Suspected Appendicitis in Adolescents and Young Adults: Review of Evidence.Korean journal of radiology · 2022Review
- Diagnostic sensitivity and specificity of 2-mSv CT vs. conventional-dose CT in adolescents and young adults with suspected appendicitis: post hoc subgroup analysis of the LOCAT data.European radiology · 2020Article
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Authors and funding
9 authors.
Funding
Abstract
purposeThis retrospective study was aimed to determine if appendiceal perforation identified pathologically but not surgically is clinically meaningful.
methodsThe study consists of 2 parts. First, we reviewed 74 studies addressing appendiceal perforation published in 2012 and 2013. Second, in a cross-sectional study, we classified 1,438 adolescents and adults (mean age, 29.3 ± 8.4 years; 785 men) with confirmed appendicitis as "nonperforation" (n = 1,083, group 1), "pathologically-identified perforation" (n = 55, group 2), "surgically-identified perforation" (n = 202, group 3), or "pathologically- and surgically-identified perforation" (n = 98, group 4). The 4 groups were compared for the frequency of laparoscopic appendectomy and the length of hospital stay using multivariable logistic regression analyses.
resultsThe reference standard for appendiceal perforation was frequently missing or inconsistent in the previous studies. Laparoscopic appendectomies were less frequent in groups 3 (52.5%, P = 0.001) and 4 (65%, P = 0.040) than in group 1 (70.7%), while group 2 (73%, P = 0.125) did not significantly differ from group 1. Median hospital stays were 2.9, 3.0, 5.1, and 6.0 days for groups 1-4, respectively. Prolonged hospital stay (≥3.7 days) was more frequent in groups 3 (77.7%, P < 0.001) and 4 (89%, P < 0.001) than in group 1 (23.4%), while group 2 (35%, P = 0.070) did not significantly differ from group 1.
conclusionWe recommend using surgical rather than pathologic findings as the reference standard for the presence of appendiceal perforation in future investigations.
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