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June 21, 2016World Journal of Emergency SurgeryOpen Access

International normalized ratio and serum C-reactive protein are feasible markers to predict complicated appendicitis

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Key result

Elevated preoperative international normalized ratio (INR) was significantly associated with a higher risk of complicated appendicitis (RR 2.06) compared to normal INR.

Why the study?

Do elevated preoperative INR and CRP predict complicated appendicitis in patients undergoing appendectomy?

Population

234 patients who underwent appendectomy, mean age 35.8 years, 126 males. Excluded patients with other…

Design

Cohort

Authors

MKMaru KimSKSung-Jeep KimHCHang Joo Cho

Discussion

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Overview

Elevated preoperative INR may aid risk stratification for complicated appendicitis; hypothesis-generating and requires prospective validation before changing practice.

Study Design

Type

Observational (n=234)

Multicenter

No

Structured PICO

Do elevated preoperative INR and CRP predict complicated appendicitis in patients undergoing appendectomy?

P
Population
234 patients with pathologically confirmed appendicitis who underwent appendectomy at a single center in South Korea.
E
Exposure
Preoperative laboratory markers (international normalized ratio [INR] and serum C-reactive protein [CRP])
O
Outcome
Complicated appendicitis (defined as perforated appendicitis, periappendiceal abscess, and peritonitis)surrogate

Main Result

Relative Risk: 2.059 (95% CI 1.032–4.108)

p-value: p=0.001

Elevated preoperative INR and CRP are feasible and cost-effective markers to predict complicated appendicitis and longer hospital stay.

Limitations

  • Small sample size
  • Retrospective single center design

Cite This Study

Kim et al. (2016) conducted an observational in Appendicitis (n=234). Elevated international normalized ratio (INR) vs. Normal INR was evaluated on Complicated appendicitis (RR 2.059, 95% CI 1.032-4.108, p=0.001). Elevated preoperative international normalized ratio (INR) was significantly associated with a higher risk of complicated appendicitis (RR 2.06) compared to normal INR.

synapsesocial.com/papers/6a9b06747cd2ce780e63bc73https://doi.org/10.1186/s13017-016-0081-6
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The diagnostic values of preoperative laboratory markers in children with complicated appendicitis2012 · 41 citations
  2. 2Causes of Short-Term Mortality After Appendectomy2011 · 65 citations
  3. 3Guidelines for the diagnosis and management of disseminated intravascular coagulation2009 · 1,129 citations
  4. 4The Epidemiology of Appendicitis and Appendectomy in South Korea: National Registry Data2010 · 227 citations
  5. 5Differentiation of Nonperforated from Perforated Appendicitis: Accuracy of CT Diagnosis and Relationship of CT Findings to Length of Hospital Stay2005 · 80 citations