Clinical Analysis On Risk Factors Of Postoperative Complications In Children With Acute Appendicitis

Background: This study investigated the main risk factors for postoperative complications of children with acute appendectomy,in order to reduce the incidence of complications,improve the prognosis of children,and provide guidance for clinical diagnosis and treatment.Methods: A retrospective study was conducted of pediatric patients with acute appendicitis and appendectomy from January 2014 till December 2018,who presented to the Pediatric Surgery,Shengjing Hospital of China Medical University.Clinical factors including age,gender,body weight,temperature,duration of clinical symptoms,white blood cell(WBC)counts on admission,Neutrophil counts(N%)on admission,the values of C-reactive protein(CRP),surgical procedure,duration of operation,abdominal drainage,pathological type,length of hospital stays,and postoperative complications were collected.Complications included wound infection,fat liquefaction,abdominal abscess,bowel obstruction,and intestinal fistula.The pediatric patients were divided into the complication group and the control group.The chi-square test or Fisher's exact test was used for the comparison between two groups,and the logistic regression was used to analyze the risk factors for complications of acute appendectomy.Results: A total of 2,289 children were enrolled in this study,including238 patients(10.4%)in the complication group and 2,051 patients(89.6%)in the control group.Compared with the control group,significant differences were demonstrated in age,surgical procedure,duration of operation,abdominal drainage and pathological type by one-way ANOVA(P<0.05).Additionally,logistic regression analysis showed that,abdominal drainage(OR=5.938,95%CI 4.371-8.067,P<0.001),open appendectomy(OR=1.707,95%CI 1.284-2.271,P<0.001),duration of surgery(OR=1.134,95%CI 1.005-1.279,P=0.040),appendicular perforation(OR=1.435,95%CI 1.023-2.013,P=0.037),and periappendiceal abscess(OR=2.087,95%CI 1.054-4.132,P=0.035)were independent risk factors for postoperative complications of children acute appendectomy.Conclusion: Open appendectomy,long time operation,abdominal drainage,pathological type including appendicular perforation and periappendiceal abscess were the main risk factors for postoperative complications of acute appendicitis in children.