The Frequency of Different Clinical Presentation of Appendicitis, Complications and Prognosis in Elderly
Mostafa Hosseini
Faculty of General Surgery, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Adnan Tizmaghz
Faculty of General Surgery, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Ghazaal Shabestanipour
Faculty of General Physician, Mofid pediatric hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ali Aein
Faculty of General Surgery, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
Hamidreza Alizadeh Otaghvar *
Faculty of General Surgery, Rasool-e-Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.
*Author to whom correspondence should be addressed.
Abstract
Background: The classic symptoms of acute appendicitis are seldom seen in the elderly patient and the diagnosis is particularly easy to miss in this group. Therefore complications are more common as a result of delayed diagnosis. The aim of this study was to identify prognosis, complications and factors associated with perforation in elderly patients with acute appendicitis.
Materials and Methods: This is a retrospective (descriptive-analytic) study which was conducted from August 2011 until October 2013 in Tehran. A sample of 76 available patients with suspected acute appendicitis –who had been admitted to Rasoul-e-Akram and firoozgar hospital were recruited to participate in this study. Patients’ demographic data, symptoms, complications and their blood samples for CRP and Leukocyte count were collected and sent to the laboratory for analysis. Statistical analysis was carried out by chi2 and independent sample t-tests.
Results: A number of 76 patients were investigated. Nearly 47.2% were male and 81% of the patients had leukocytosis. 15% of patients had normal appendix. Sensitivity and specificity value of WBC was higher than other markers. 14.4% of patients were died. Age, gender, pain duration, fever, leukocytosis and anorexia were 6 factors which affected prognosis of patients.
Conclusion: The results of this study showed that in addition to physical examination, some basic laboratory findings such as CRP and leukocytosis can be helpful also it seems some factors such as duration of pain could affected outcomes of patients.
Keywords: Acute appendicitis, perforation, complication, elderly people