Factores predictores para apéndice blanca y apendicitis aguda en pacientes sometidos a apendicectomía. Experiencia de dos años en una institución privada

Introduction.Acute appendicitis (AA) is the most common indication for emergency abdominal surgery, 10-20% of these are reported as negative appendectomy (NA). It has been attempted to reduce this incidence with new imaging studies and clinical diagnosis criteria. There are several pathologies that can mimic AA as well as many factors that are associated to an increased in the incidence of a NA. Objective.Define the frequency of NA in patients undergoing appendectomy from any cause in a private hospital and the variables that suggest or not the presence of AA. Material and Material and Material and Material and Material and methods. A retrospective study was conducted in 683 patients who underwent appendectomy during 2009 and 2010 at a private hospital in Mexico City. Age, gender, use of preoperative TAC, leukocytosis, associated diseases, phase of appendicitis reported by the surgeon and correlation with pathology report were analyzed. For categorical and discrete variables an univariate, bivariate and binary logistic regression model analysis was performed in order to identify risk factors associated with the presence or absence of AA and NA. Results.From the 683 patients analyzed, 51.5% were female. Mean age was 31.0 ± 17.1 years. From all patients, 87.2% were positive and 12.9% were reported as NA. 77.7% had leukocytosis. Preoperative TAC was performed to 66% of patients with diagnosis of AA, in contrast, only 43.2% with NA had preoperative TAC (p < 0.0001). Conclusions.Male, age less than 30 years, presence of leukocytosis and the use of preoperative TAC are suggestive factors of AA in clinically suspected patients.