• Gaetano Poillucci, Mauro Podda, Adolfo Pisanu, Lorenzo Mortola, Patrizia Dalla Caneva, Giulia Massa, Gianluca Costa, Riccardo Savastano, Nicola Cillara, and ERASO (Elderly Risk Assessment And Surgical Outcome) Collaborative Study Group.
• Department of General Surgery "Paride Stefanini", Policlinico Universitario Umberto I, Sapienza University, Rome, Italy.
• Eur J Trauma Emerg Surg. 2021 Dec 1; 47 (6): 1729-1737.

BackgroundA limited number of studies investigating perioperative risk factors associated with emergency appendectomy in elderly patients have been published to date. Whether older age may be associated with poorer outcomes following appendectomy is still a matter of debate. The primary aim of this study was to determine the predictors of postoperative morbidity following appendectomy in patients aged ≥ 65 years.MethodsData regarding all elderly patients who underwent emergency appendectomy from January 2017 to June 2018 admitted 36 Italian surgical departments were prospectively collected and analyzed. Baseline demographics and perioperative variables were evaluated. Uni- and multivariate analyses adjusted for differences between groups were carried out to determine possible predictors of adverse outcomes after appendectomy.ResultsBetween January 2017 and June 2018, 135 patients aged ≥ 65 years with a diagnosis of AA met the study inclusion criteria. Twenty-six patients (19.3%) were diagnosed with some type of postoperative complication. Decreasing the preoperative hemoglobin level showed a statistically significant association with postoperative complications (OR 0.77, CI 0.61-0.97, P = 0.03). Preoperative creatinine level (P = 0.02, OR 2.04, CI 1.12-3.72), and open appendectomy (P = 0.03, OR 2.67, CI 1.11-6.38) were significantly associated with postoperative morbidity. After adjustment, the only independent predictor of postoperative morbidity was preoperative creatinine level (P = 0.04, OR 2.01, CI 1.05-3.89).ConclusionsIn elderly patients with AA, perioperative risk assessment in the emergency setting must be as accurate as possible to identify modifiable risk factors that can be addressed before surgery, such as preoperative hemoglobin and creatinine levels.© 2019. Springer-Verlag GmbH Germany, part of Springer Nature.

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