K. Sanner Dixon1, J. Hartwell1 1University of Kansas Medical Center, Emergency General Surgery/Trauma Surgery, Kansas City, KANSAS, USA
Introduction: There are many factors that contribute to perioperative morbidity, including age, previous medical history, medications, and social history. Previous studies have reported complications to be as low as 6% and as high as 25-35% . This study evaluated the demographics, modifiable risk factors, and treatment modalities of patients at an academic institution and whether those factors were likely to contribute to post-operative complications.
Methods: All patients who underwent appendectomy from July 2022 to December 2023 at an academic center were included for study and included 158 patients. Exclusion criteria included those patients whose appendicitis was managed non-operatively. Patient charts were reviewed for demographics, modifiable risk factors, and complications. Demographic variables included race, ethnicity, language, age, and sex. Multiple modifiable preoperative and postoperative risk factors were assessed, including medical history, immunosuppression, medications, smoking status, antibiotic administration, surgical instruments, surgical technique, and complication type (see table).
Results: The only factors that were found to have a statistically significant impact on post-operative complications were AAST grade (<0.001) and administration of post-operative antibiotics (<0.001). Other modifiable factors did not show any statistical significance including diabetes mellitus type 1 (>0.999) and type 2 (0.053), smoking status (0.663), age (0.078), chemotherapy (0.408), and steroids (0.637).
Conclusion: While some factors contributed to clinically significant differences in post-operative appendectomy complications, the only statistically significant factors impacting post-operative complications were AAST grade and post-operative antibiotic administration. Common factors known to contribute to perioperative complications – including diabetes, smoking status, age, chemotherapy, and steroid use – were found to have no statistically significant effect on likelihood to develop a post-operative complication. Limitations include small sample size and single institution. Future studies should assess these factors and their contribution to post-operative complications in a larger, multi-institution study. Additional studies should evaluate post-operative antibiotics driven by AAST grade.