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J Korean Soc Emerg Med > Volume 29(6); 2018 > Article
Journal of The Korean Society of Emergency Medicine 2018;29(6): 671-678.
응급의료센터를 방문한 성인 급성 충수염 환자에서 재실 기간의 연장을 예측하는 인자에 대한 비교연구
장영재1, 김신영1, 홍대영1, 백광제1, 박상오1, 김종원1, 김진용2, 이경룡1
1건국대학교 의학전문대학원 응급의학교실
2건국대학교 의과대학 충주병원 응급의학과
The comparative study of predictive factors for prolonged length of stays that adult patients with acute appendicitis in emergency department
Young Jae Jang1, Sin Young Kim1, Dae Young Hong1, Kwang Je Baek1, Sang O Park1, Jong Won Kim1, Jin Yong Kim2, Kyeong Ryong Lee1
1Department of Emergency Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
2Department of Emergency Medicine, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
Correspondence  Kyeong Ryong Lee ,Tel: 02-2030-5551, Fax: 02-2030-5789, Email: lkrer@kuh.ac.kr,
Received: June 4, 2018; Revised: July 26, 2018   Accepted: September 21, 2018.  Published online: December 31, 2018.
ABSTRACT
Objective:
This study examined the predictive factors for prolonged length of stays of adult patients with acute appendicitis (AA) in an emergency department (ED).
Method:
This was a retrospectively clinical study including patients in an ED. All patients were diagnosed from the clinical symptoms and a typical physical examination, and had undergone a computed tomography (CT) evaluation on the ED visiting date. All data were collected from the electrical medical records. The clinical parameters analyzed were the laboratory data, including the white blood cell count with differential values, C-reactive protein (CRP) level, initial vital signs, duration of admission, coexisting perforation of the appendix in the CT findings. The relationship between the clinical parameters and length of stay was assessed.
Results:
A total of 547 patients with AA were enrolled in this study. Among them, there were 270 male patients with a mean age of 40.7±15.8 years. The baseline characteristics, initial clinical features, laboratory, and imaging studies results of 129 patients in the prolonged length of stay (pLOS) group, and 418 patients of the non-pLOS group in AA were compared. Multivariable logistic regression analysis revealed the predictive factors related to pLOS in AA to be as follows: age 40 years or older, body temperature over 37.3oC, CRP level greater than 5.0 mg/dL, and evidence of perforation in CT findings (P<0.001).
Conclusion:
If we check age, fever, CRP level and find evidence of perforation, it might be helpful for predicting the increasing period of length of hospital stay for patients with AA in ED.
Key words: Appendicitis; Length of stay; Hospitalization; Diagnosis-related groups
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