Giulia Mauri (Milan / IT; Pieve Emanuele / IT), Simone Giudici (Pieve Emanuele / IT; Milan / IT), Francesca Margherita Bunino (Milan / IT; Pieve Emanuele / IT), Mattia Gritti (Pieve Emanuele / IT; Milan / IT), Anastasia Baire (Pieve Emanuele / IT; Milan / IT), Martina Ceolin (Milan / IT), Andrea Brocchi (Milan / IT), Antonella Ardito (Milan / IT), Simona Mei (Milan / IT), Bruno Branciforte (Milan / IT), Daniele Del Fabbro (Milan / IT)
Abstract text (incl. references and figure legends)
I: The aim of the study is to assess the role of CRP values in detecting complex appendicitis and to debate the effects of delayed appendectomy, analyzing the complication rate and the hospitalization length.
M: We retrospectively considered 412 patients who underwent surgery for acute appendicitis from January 2015 to December 2021 at Humanitas Research Hospital, Milan. Admission CRP value and timing (<12h; 12-24h;>24h) between Emergency Room (ER) access and surgery has been collected for every patient. Intra-Operatory (IO) findings according to AAST, post-operative stay and complication rate, according with Clavien Dindo Classification, were evaluated.
R: 168 patients (41%) had complicated appendicitis (AAST 3-4-5), while 244 patients (59%) had uncomplicated appendicitis (AAST 1-2). Admission CRP levels were higher in patients with complicated appendicitis (p-value 0.002). Median in hospital delay were 20 hours. 102 patients underwent surgery within 12 hours of admission to ER, 174 between 12-24 h and 136 over 24h, respectively. Patients with uncomplicated appendicitis were more in the 12-24h group than in the >24h group (p 0.015). No statistically differences were found between timing of surgery and IO findings for the other groups. No differences found for hospitalization length and complications rate between the three groups. CRP levels did not relate with complications, but high levels of CRP linked with longer hospitalization (p 0. 002).
C: High CRP values on admission can help to detect complicated appendicitis and longer hospitalization. Prolonged in-hospital delays before appendectomy, nor CRP levels, was not associated with increased risk of complicated appendicitis or adverse outcomes.
R: C-Reactive protein is an independent surgical indication marker for appendicitis: a retrospective study. Shozo Yokoyama et al. World Journal of Emergency Surgery volume 4: 36 (2009).
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