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2026, Number 4

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Acta Med 2026; 24 (4)

Complicated appendicitis in children: clinical, laboratory, and imaging predictors identified through multivariate analysis

Montcharmont SSE, Bravo RFM, Riba OM, Fernández VS, Silva RH

Language: Spanish
References: 30
Page: 405-410
PDF size: 571.24 Kb.


ABSTRACT

Introduction: acute appendicitis is the most common surgical abdominal emergency in pediatrics. Its complicated forms (gangrenous, perforated, or abscessed) are associated with higher morbidity, longer hospital stay, and increased costs. Identifying early predictors is essential to optimize management. Material and methods: retrospective study of patients < 18 years with histopathological diagnosis of acute appendicitis treated at a private tertiary hospital (January 2019-March 2024). Complete records with clinical, laboratory, and imaging variables at admission were analyzed. Complicated appendicitis was defined as gangrenous, perforated, or abscessed. Descriptive statistics, bivariate analysis, and multivariate logistic regression were applied, reporting odds ratios (OR) with 95% confidence intervals (95% CI). Results: a total of 134 patients were analyzed; 38 (28.3%) had complicated appendicitis. In multivariate analysis, fever (OR 5.58; 95%CI 1.89-16.42; p = 0.002), hyponatremia (OR 0.75; 95%CI 0.60- 0.92; p = 0.004), bandemia (OR 1.22; 95%CI 1.09-1.36; p = 0.001), and appendicolith (OR 1.42; 95%CI 1.10-1.83; p = 0.006) were significant predictors. Conclusions: fever, bandemia, hyponatremia, and appendicolith are accessible predictors that allow early risk stratification and support clinical decision-making in pediatric appendicitis.


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