Blood culture positivity in patients with acute appendicitis: A propensity score-matched prospective cohort study

被引:2
作者
Sula, Sami [2 ,3 ,4 ]
Han, Tatu [3 ,5 ]
Marttila, Harri [6 ]
Haijanen, Jussi [2 ,3 ]
Loyttyniemi, Eliisa [7 ]
Sippola, Suvi [2 ,3 ]
Gronroos, Juha [2 ,3 ]
Hakanen, Antti J. [8 ,9 ]
Salminen, Paulina [1 ]
机构
[1] Turku Univ Hosp, Div Digest Surg Urol, Surg, POB 52, Turku 20520, Finland
[2] Turku Univ Hosp, Div Digest Surg & Urol, Turku, Finland
[3] Univ Turku, Dept Surg, Turku, Finland
[4] Satasairaala Cent Hosp, Pori, Finland
[5] Univ Turku, Fac Med, Turku, Finland
[6] Turku Univ Hosp, Dept Hosp Hyg & Infect Control, Turku, Finland
[7] Univ Turku, Dept Biostat, Turku, Finland
[8] Turku Univ Hosp, Dept Clin Microbiol, Lab Div, Turku, Finland
[9] Univ Turku, Inst Biomed, Res Ctr Infect & Immun, Turku, Finland
基金
芬兰科学院;
关键词
Blood culture; bacteremia; acute appendicitis; septicemia; blood stream infection; UNCOMPLICATED ACUTE APPENDICITIS; ANTIBIOTIC-THERAPY; APPENDECTOMY; BACTEREMIA;
D O I
10.1177/14574969221110754
中图分类号
R61 [外科手术学];
学科分类号
摘要
Background and objective: The prevalence of bacteremia in acute appendicitis is unknown. We aimed to assess prevalence and predictive factors of bacteremia in adult patients with appendicitis. Methods: In this prospective propensity score-matched cohort study, patients were recruited as part of one single-center prospective observational study assessing appendicitis microbiology in concurrence with two randomized controlled trials on non-operative treatment of uncomplicated acute appendicitis. All patients evaluated for enrollment in these three trials between April 2017 and December 2018 with both a confirmed diagnosis of appendicitis and available blood culture on admission were included in this study. Potential predictive factors of bacteremia (age, sex, body mass index (BMI), body temperature, C-reactive protein (CRP), leukocyte count, comorbidities, symptom duration, and appendicitis severity) were assessed. Prevalence of bacteremia was determined by all available blood cultures followed by propensity score matching using sex, age, BMI, CRP, leukocyte count, and body temperature of the patients without available blood culture. Results: Out of the 815 patients with appendicitis, 271 patients had available blood culture and the prevalence of bacteremia was 12% (n = 33). Based on propensity score estimation, the prevalence of bacteremia in the whole prospective appendicitis cohort was 11.1%. Bacteremia was significantly more frequent in complicated acute appendicitis (15%; 29/189) compared with uncomplicated acute appendicitis (5%; 4/82) (p = 0.015). Male sex (p = 0.024) and higher body temperature (p = 0.0044) were associated with bacteremia. Conclusions: Estimated prevalence of bacteremia in patients with acute appendicitis was 11.1%. Complicated appendicitis, male sex, and higher body temperature were associated with bacteremia in acute appendicitis.
引用
收藏
页码:31 / 38
页数:8
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