Clinical significance of peri-appendiceal abscess and phlegmon in acute complicated appendicitis patients undergoing emergency appendectomy

Table 1 Baseline clinical characteristics of the patients, n (%)

Characteristic
All patients	234 (100)
Age, median (range), years	60 (18-87)
Sex
Female	100 (42.7)
Male	134 (57.3)
White blood cell count, mean (SD), × 109/L	13.4 (5.2)
Granulocyte percentage, mean (SD)	88.9 (4.8)
Appendicolith	132 (56.4)
Peri-appendiceal abscess	151 (64.5)
Peri-appendiceal phlegmon	83 (35.5)
Pathology
Acute appendicitis	228 (97.4)
Appendiceal adenocarcinoma	4 (1.7)
Appendiceal neuroendocrine neoplasm	1 (0.4)
Appendiceal mucinous neoplasm	1 (0.4)

Table 2 Correlation between clinical factors and peri-appendiceal abscess or phlegmon

Characteristic	Peri-appendiceal		χ²	P value
	Abscess	Phlegmon
All patients	151	83
Age (years)1			0.004	0.947
≤ 60	83	46
> 60	68	37
Sex			0.017	0.897
Female	65	35
Male	86	48
Temperature			0.009	0.923
≤ 37 °C	50	28
> 37 °C	101	55
White blood cell count, × 109/L			0.183	0.668
≤ 9.5	44	22
> 9.5	107	61
Granulocyte percentage			0.142	0.557
≤ 80%	36	17
> 80%	115	66
Duration of symptoms			17.663	< 0.001
≤ 72 h	69	71
> 72 h	82	12
Appendicolith			5.908	0.015
Yes	94	38
No	57	45

¹Split at median.

Table 3 Cox regression analyses for postoperative length of hospital stay

Characteristic	Length of hospital stay (d)	Hazard radio (95%CI)	P value
Age (years)1			0.913
≤ 60	6.0 (4.0, 8.0)	1.000 (reference)
> 60	6.0 (4.0, 8.0)	0.997 (0.946-1.050)
Sex			0.327
Male	6.0 (4.0, 8.0)	1.000 (reference)
Female	6.0 (4.0, 8.0)	1.027 (0.974-1.083)
Temperature			0.745
≤ 37 °C	6.0 (4.0, 7.0)	1.000 (reference)
> 37 °C	6.0 (4.0, 8.0)	1.009 (0.954-1.068)
WBC count, × 109/L			0.981
≤ 9.5	6.0 (4.0, 7.0)	1.000 (reference)
> 9.5	6.0 (4.0, 8.0)	1.001 (0.945-1.060)
Granulocyte percentage			0.097
≤ 80%	5.0 (3.0, 7.5)	1.000 (reference)
> 80%	6.0 (4.0, 8.0)	1.081 (0.986-1.185)
Duration of symptoms			< 0.001
≤ 72 h	5.0 (4.0, 7.0)	1.000 (reference)
> 72 h	7.0 (5.0, 10.0)	1.208 (1.107-1.319)
Appendicolith			0.699
No	6.0 (4.0, 8.0)	1.000 (reference)
Yes	6.0 (4.0, 8.0)	1.010 (0.959-1.064)
Peri-appendiceal			< 0.001
Phlegmon	5.0 (4.0, 7.0)	1.000 (reference)
Abscess	6.0 (5.0, 8.0)	1.217 (1.095-1.352)

¹Split at median.

Table 4 Correlation between surgical factors and peri-appendiceal abscess or phlegmon

Characteristic	Peri-appendiceal		χ²	P value
	Abscess	Phlegmon
Surgical site infections by type			21.254	< 0.001
Superficial	14	1
Deep incisional	6	0
Organ/space	2	0
Incisional hernias	1	0	0.552	0.457
Surgery			19.438	< 0.001
Laparoscopic appendectomy	56	49
Open appendectomy	44	5
Conversion to open appendectomy	51	29