Introduction: Acute appendicitis is the most common emergency condition in pediatric surgery. Complicated appendicitis, classified as gangrene or perforated, creates a high burden for pediatrics health care system.
Aim: To identify predictors as recorded at admission for postoperative complications following complicated appendicitis in pediatric population.
Methods: Epidemiological, clinical and laboratory data were retrospectively collected for cases defined pathologically as complicated appendicitis between 2012-2015 at Schneider Children`s Medical Center. Potential correlation between these factors and morbidity, length of hospital duration and complications were tested.
Results: Two independent predictors for longer hospital duration were found on multivariate analysis. Longer duration of fever prior to admission (OR 1.815; 95% CI 1.074-3.067, P=0.26) and CRP levels >10 mg/dL (OR 20.494; 95% CI 1.775-236.607, P=0.016). A discrepancy between the surgical and the pathological report was found in 11.7% of cases, all of which were classified intra-operatively as gangrenous. This group demonstrated lower rates of postoperative complications, shorter duration of hospital stay without readmissions.
Conclusions: prolonged hospital stay of pediatric complicated appendicitis may be predicted by the above mentioned preoperative risk factors, that may help define high-risk subgroup of children who will likely benefit from early detection. The operative diagnosis may better predict outcomes, suggesting treating operative finding of gangrenous as with acute simple appendicitis protocols.
