NGHIÊN CỨU CÁC YẾU TỐ DỰ ĐOÁN VIÊM RUỘT THỪA CẤP CÓ BIẾN CHỨNG Ở NGƯỜI LỚN

Abstract

Background: Acute appendicitis (AA) is a common surgical disease in clinical practice, in which the surgeon needs to distinguish AA with complications and without complications. Building a predictive model for AA with complications to help the clinicians predict disease status and decide on necessary treatment. We conduct research with two main objectives: - Determine the clinical signs, and CT images related to complicated AA. - Build a multivariable model to predict complicated AA with clinical factors, and CT images. Materials & Methods: A case-control study, retrospectively study on cases of complicated AA that were operated at Trung Vuong hospital from January 2017 to March 2019. Collect clinical factors  and computed tomography images related to complicated AA. Using logistic regression analysis to conducting a multivariate model of predictors of complicated AA. Results: 205 cases of AA that met the sampling criteria were included in the study. Through data analysis, there are 2 clinical factors (pain duration more than 48 hours and white blood cell count ≥ 13K/ul) and 9 signs on CT images related to the status of complicated AA. The logistic regression model predicts the status of complicated AA including the following factors: age ≥ 45 years, pain duration > 48 hours, white blood cell count ≥ 13K/ul, peri-appendiceal infiltrates, presence of fecal stones, paralytic ileus and gas in the lumen of the appendix. Conclusion: It is necessary to consider the status of complicated AA in patients ≥ 45 years old, with pain duration > 48 hours, with leukocytosis 13 k/uL and the following signs on X-ray film: complete infiltrate RT circumference, presence of fecal stones, paralytic status, presence of air in the appendix lumen.