Early factors associated with negative appendectomy

Factores tempranos asociados a apendicectomía negativa Early factors associated with negative appendectomy

Published 2021-03-19


https://doi.org/10.30554/archmed.21.2.4004.2021
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Vol. 21 No. 2 (2021): .
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Ortiz Vásquez, J. J. ., Gómez Aristizábal, L. I. ., Correa Ángel, M. A., Díaz Gómez, E. ., Amarrillo Ortiz, O. A. ., Toro Rivera, A. ., Ramírez Nieto, G. L. ., & Rojas Gualdrón, D. F. . (2021). Early factors associated with negative appendectomy: Early factors associated with negative appendectomy. Archivos De Medicina , 21(2). https://doi.org/10.30554/archmed.21.2.4004.2021
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Ortiz Vásquez, J. J. ., Gómez Aristizábal, L. I. ., Correa Ángel, M. A., Díaz Gómez, E. ., Amarrillo Ortiz, O. A. ., Toro Rivera, A. ., Ramírez Nieto, G. L. ., & Rojas Gualdrón, D. F. . (2021). Early factors associated with negative appendectomy: Early factors associated with negative appendectomy. Archivos De Medicina , 21(2). https://doi.org/10.30554/archmed.21.2.4004.2021

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Juan José Ortiz Vásquez
Universidad CES
https://orcid.org/0000-0003-3475-9819 ORCID
Laura Isabel Gómez Aristizábal
Universidad CES
https://orcid.org/0000-0002-2916-2041 ORCID
Maria Antonia Correa Ángel
Universidad CES
https://orcid.org/0000-0001-9121-508X ORCID
Estefanía Díaz Gómez
Universidad CES,
https://orcid.org/0000-0003-3774-5164 ORCID
Oscar Alfredo Amarrillo Ortiz
https://orcid.org/0000-0001-8007-3282 ORCID
Alejandro Toro Rivera
Universidad CES
https://orcid.org/0000-0001-9497-0400 ORCID
Gabriel Leonardo Ramírez Nieto
Universidad CES
https://orcid.org/0000-0001-6330-8297 ORCID
Diego Fernando Rojas Gualdrón
https://orcid.org/0000-0002-2293-0431 ORCID
Show authors biography

Juan José Ortiz Vásquez,

Estudiante de Medicina, Facultad de Medicina, Universidad CES, Medellín

Laura Isabel Gómez Aristizábal,

Estudiante de Medicina, Facultad de Medicina, Universidad CES, Medellín, Colombia. ORCID: 

Maria Antonia Correa Ángel,

Estudiante de Medicina, Facultad de Medicina, Universidad CES, Medellín, Colombia. 

Estefanía Díaz Gómez,

Estudiante de Medicina, Facultad de Medicina, Universidad CES, Medellín,

Oscar Alfredo Amarrillo Ortiz

Estudiante de Medicina, Facultad de Medicina, Universidad CES, Medellín, Colombia

Alejandro Toro Rivera,

Estudiante de Medicina, Facultad de Medicina, Universidad CES, Medellín, Colombia

Gabriel Leonardo Ramírez Nieto,

MD, Especialista en Medicina de Urgencias, Facultad de Medicina, Universidad CES. Docente adscrito Universidad CES, Coordinador médico de urgencias Clínica CES, Medellín

Diego Fernando Rojas Gualdrón

PhD, Doctor en Epidemiología y Bioestadística, Magister en Psicología, Magister en E-learning, Especialista en Dirección de Empresas, Psicólogo. Facultad de Medicina y Escuela de Graduados, Universidad CES, Medellín, Colombia.

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Abstract

 

Objective. To analyze predictive characteristics of negative appendectomy (NA) in a cohort of patients who underwent surgery during 2018 in a high complexity healthcare institution in the city of Medellín, Colombia. Materials and Methods. Retrospective follow-up to a cohort based on medical records. We analyzed adult patients who underwent appendectomy. We stimated the rate of AN and described the clinical, paraclinical and sociodemographic characteristics. The analysis of predictors of AN was carried out using the generalized linear model binomial family, logarithmic link. Observed and adjusted risk ratios (RR) are presented along with 95% confidence intervals (95% CI). For the multivariate model, the area under the receiver operator curve (ROC) was estimated. Results. The AN rate was 5.2%. Abdominal computed tomography (CT) was not requested in 48.9% of the cases, 4.1% of the patients had dysuria. Among the factors studied, dysuria, non-request for CT, age and leukocytosis were significantly associated with a higher risk of AN. Is worth noting that the adjusted risk of AN of the patients who presented with dysuria and those in which no CT was requested, was 30.3% (RR = 17.31; 95% CI 5.00 - 59.87). ROC was 0.834. Conclusions. When defining the need for diagnostic imaging and surgical management of patients with suspected acute appendicitis, patients who report dysuria are high risk group of negative appendectomy, which could be suggestive of the need for CT.

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