Risk Factors of Recurrent Appendiceal Abscess After Initial Nonsurgical Treatment Without Drainage of Children With Appendiceal Abscess: A Single Center Retrospective Review

作者全名："Luo, PengCheng; Wang, DengLiang; Kang, Quan"

作者地址："[Luo, PengCheng; Wang, DengLiang; Kang, Quan] ChongQing Med Univ, Childrens Hosp, Dept Gen Trauma Surg, Key Lab Child Dev & Disorders,Chongqing Key Lab Pe, Chongqing, Peoples R China; [Kang, Quan] ChongQing Med Univ, Childrens Hosp, Dept Gen Trauma Surg, Chongqing Key Lab Pediat,Key Lab Child Dev & Disor, Chongqing 400014, Peoples R China"

通信作者："Kang, Q (通讯作者)，ChongQing Med Univ, Childrens Hosp, Dept Gen Trauma Surg, Chongqing Key Lab Pediat,Key Lab Child Dev & Disor, Chongqing 400014, Peoples R China."

来源：SURGICAL INFECTIONS

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:000884291000001

JCR分区：Q3

影响因子：2

年份：2022

卷号：　

期号：　

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结束页：　

文献类型：Review; Early Access

关键词：appendiceal abscess; children; non-surgical treatment; recurrence; risk factors

摘要："Background: Exploration of the risk factors of recurrent appendiceal abscess after initial non-surgical treatment without drainage in children with appendiceal abscess.Patients and Methods: The medical records of all children diagnosed with appendiceal abscess and who were treated conservatively in the Children's Hospital of Chongqing Medical University from June 2012 to June 2020 were collected. The collected cases were divided into the recurrent group and the non-recurrent group, and all clinical indicators were compared. Logistic regression analysis was used to determine the risk factors for recurrent appendiceal abscess in children.Results: One hundred twenty-four patients were included and among them, 62 (50.0%) had clinical manifestations of recurrent appendiceal abscess (the recurrent group) and five patients (8%) suffered several instances of recurrence. Duration of intravenous antibiotic agents (odds ratio [OR], 0.905; 95% confidence interval [CI], 0.820-1.000) was independently associated with the recurrence of appendiceal abscess. The risk of recurrence was increased in children with the white blood cell (WBC) count at discharge greater than 8 x 10(9)/L (OR, 2.702; 95% CI,1.172-6.231), the ratio of mass size to body surface area (BSA) at discharge greater than 4.255 (OR, 1.369; 95% CI, 1.104-1.697), and without continuous oral antibiotic agents after discharge (OR, 3.111; 95% CI, 1.240-7. 802).Conclusions: Interval appendectomy is recommended for children with WBC count at discharge greater than 8 x 10(9)/L, and the ratio of mass size to BSA at discharge greater than 4.255, because they are more likely to develop recurrent appendiceal abscess after initial conservative treatment. The duration of intravenous antibiotic agents is an independent factor of the recurrence of appendiceal abscess, and a longer course of intravenous antibiotic agents is strongly associated with a reduced risk of recurrence. Continued oral antibiotic agents after discharge can effectively reduce the risk of recurrence of appendiceal abscesses."

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