Influence of Delays on Perforation Risk in Adults with Acute Appendicitis

Kearney, D.; Cahill, R. A.; O'Brien, E.; Kirwan, W. O.; Redmond, H. P.

doi:10.1007/s10350-008-9373-6

Cited by 108Appendicitis Diagnosis and ManagementEmergency and Acute Care StudiesStreptococcal Infections and Treatments

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Influence of Delays on Perforation Risk in Adults with Acute Appendicitis

Kearney, D., Cahill, R. A., O'Brien, E., Kirwan, W. O., Redmond, H. P.·2008·Diseases of the Colon & Rectum

DOI 10.1007/s10350-008-9373-6

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Abstract

PURPOSE: This study analyzed whether prehospital or in-hospital delay was the more significant influence on perforation rates for acute appendicitis and whether any clinical feature designated patients requiring higher surgical priority. METHODS: A retrospective analysis was conducted over one year at a tertiary referral hospital without a dedicated emergency surgical theater. Admission notes, theater logbook, and the Hospital Inpatient Enquiry system were reviewed to identify the characteristics and clinical course of patients aged greater than 16 years who were operated upon for histologically confirmed acute appendicitis. RESULTS: One hundred and fifteen patients were studied. The overall perforation rate was 17 percent. The mean duration of symptoms prior to hospital presentation was 38.1 hours with the mean in-hospital waiting time prior to operation being 23.4 hours. Although body temperature on presentation was significantly greater in patients found to have perforated appendicitis (P < 0.05), only patient heart rate at presentation and overall duration of symptoms, but not in-hospital waiting time, independently predicted perforation by stepwise linear regression modeling. CONCLUSION: In-hospital delay was not an independent predictor of perforation in adults with acute appendicitis although delays may contribute if patients are left to wait unduly. Tachycardia at presentation may be a quantifiable feature of those more likely to have perforation and who should be given higher surgical priority.

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Patients presenting to the hospital more than 24 hours after onset of symptoms are at higher risk of perforated appendicitis.
“it has been described that patients presenting to the hospital more than 24hrs after the onset of symptoms are at higher risk of suffering from perforated appendicitis. 9,10”
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Authors: Kearney, D., Cahill, R. A., O'Brien, E., Kirwan, W. O., & Redmond, H. P.
Affiliations: Cork University Hospital (IE)
ORCID: Kearney, D.
Cahill, R. A.
Redmond, H. P.
Venue: Diseases of the Colon & Rectum
Publisher: Ovid Technologies (Wolters Kluwer Health)
Published: 2008-12
Volume: 51
Issue: 12
Pages: 1823-1827
ISSN: 0012-3706 (ISSN-L)
DOI: 10.1007/s10350-008-9373-6
OpenAlex: W2057072643
Cited by: 108
References: 20
Citations by year: 2026: 2 · 2025: 3 · 2024: 6 · 2023: 9 · 2022: 11 · 2021: 6 · 2020: 4 · 2019: 11 · 2018: 4 · 2017: 6 · 2016: 8 · 2015: 9 · 2014: 4 · 2013: 5 · 2012: 6
FWCI: 5.13
Type: journal article
Language: en
Open access: closed
Locations: Diseases of the Colon & Rectum (publishedVersion)
PubMed (publishedVersion)
Lenus, The Irish Health Repository (Dr Steevens Hospital Library) (submittedVersion)
Topics: Health Sciences › Medicine › Emergency Medicine › Appendicitis Diagnosis and Management
Health Sciences › Medicine › Emergency Medicine › Emergency and Acute Care Studies
Health Sciences › Medicine › Infectious Diseases › Streptococcal Infections and Treatments
Keywords: acute appendicitis, appendiceal perforation, prehospital delay, in-hospital delay, surgical priority, tachycardia, fever, symptom duration, emergency surgery
MeSH terms: Adult, Appendectomy, Appendicitis, Emergency Service, Hospital, Female, Humans, Length of Stay, Male, Middle Aged, Retrospective Studies, Risk Factors, Time Factors, Triage, Cohort Studies, Linear Models

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Influence of Delays on Perforation Risk in Adults with Acute Appendicitis

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