• Michal Pedziwiatr, Anna Lasek, Michal Wysocki, Judene Mavrikis, Piotr Mysliwiec, Maciej Bobowicz, Wojciech Karcz, Maciej Michalik, Wojciech Makarewicz, Piotr Major, Mateusz Rubinkiewicz, Tomasz Stefura, Jakub Kenig, Malgorzata Polanska-Plachta, and Pol-LA Polish Laparoscopic Appendectomy.
• 2nd Department of General Surgery, Jagiellonian University Medical College, Kraków-Poland.
• Ulus Travma Acil Cer. 2019 Mar 1; 25 (2): 129-136.

BackgroundPreoperative classification of complicated and uncomplicated appendicitis (AA) is challenging. However, the differences in surgical outcomes necessitate the establishment of risk factors in developing, complicated AA. This study was an analysis of the clinical outcomes of laparoscopic appendectomies (LA), as well as preoperative risk factors for the development of complicated AA.MethodsThe data of 618 patients who underwent LA in 18 surgical units across Poland and Germany were collected in an online web-based database created by the Polish Videosurgery Society. The surgical outcomes of patients with complicated and uncomplicated appendicitis were compared. Uni- and multivariate logistic regression models were used to establish risk factors for the development of complicated appendicitis.ResultsIn all, 1269 (27.5%) patients underwent LA for complicated appendicitis (Group 1) and 3349 (72.5%) for uncomplicated appendicitis (Group 2). The conversion rate, number of intra-operative adverse events, re-intervention rate, postoperative complications, and readmission rate was greater in Group 1. The preoperative risk factors associated with complicated appendicitis were: female sex (Odds ratio [OR]: 1.58), obesity (OR: 1.51), age >50 years (OR: 1.51), symptoms >48 hours (OR: 2.18), high Alvarado score (OR: 1.29 with every point), and C-reactive protein level >100 mg/L (OR: 3.92).ConclusionSeveral demographic and clinical risk factors for complicated AA were identified. LA for complicated appendicitis was associated with poorer outcomes.

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