Pre-appendectomy hyponatremia is associated with increased rates of complicated appendicitis.
Pre-appendectomy hyponatremia is associated with increased rates of complicated appendicitis.
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DOI：
10.1016/j.sopen.2023.05.001
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发表时间：
2023-06
影响因子：
1.4
通讯作者：
Alter, Jonathan A.
中科院分区：
文献类型：
--
作者：
Poston, Lauren M.;Leavitt, Tripp;Pope, Samantha;Hill, Hannah;Tollinche, Luis E.;Kaelber, David C.;Alter, Jonathan A.
急性阑尾炎是全世界最常见的外科紧急情况之一，对复杂的阑尾炎的风险进行了术前评估，我们试图调查伴伴切除术前炎性疾病和阑尾炎的诊断。
Trinetx平台是一个联邦健康研究网络，该网络汇总了全美国超过9000万名患者的电子健康记录数据，该数据已从2019年1月开始接受阑尾切除术的患者，并从妇产科中至少有一个钠的价值，该研究人群分层为三个年龄组：年龄段（年龄<18-18-18-18-18）。 （≥65岁）。
在符合纳入标准的6155例患者中，有17,546例在改善匹配之后进行分析。 ATED增加了复杂阑尾炎诊断的几率，但是在较小程度上（OR = 2.11，95％CI [1.92，2.32]（OR = 1.49，95％CI [1.25，1.77]）。
在对急性阑尾炎的匹配患者的大量分析中，我们发现术前低钠血症与复杂的阑尾炎之间存在关联。
这项研究表明，低钠血症是多种变量之一，将其纳入复杂急性阑尾炎的未来临床决策工具中。
术前低钠血症的复杂阑尾炎的几率增加
在儿科阑尾炎患者低钠血症患者中观察到的最大作用
所有年龄段的老年人的阑尾炎几率最低。
术前低钠血症患者中简单的阑尾炎不太常见
Acute appendicitis is one of the most common surgical emergencies worldwide. Preoperative assessment of the risk of complicated appendicitis may aid in treatment planning. We sought to investigate the association between pre-appendectomy hyponatremia and diagnosis of complicated appendicitis. The TriNetX platform, a federated health research network that aggregates de-identified electronic health record data of over 90 million patients across the United States, was queried for patients who underwent appendectomy starting January 2019 and who had at least one sodium value from the preoperative period. The study population was stratified into three age groups: pediatric (age < 18), adult (age 18–64), and older adult (age ≥ 65). These groups were subdivided into patients with preoperative hyponatremia (<135 mmol/L) and normonatremia (135–145 mmol/L). Among the 61,245 patients who met inclusion criteria, 17,546 were included for analysis following propensity score matching. The odds of complicated appendicitis were highest in pediatric patients (age < 18) with pre-appendectomy hyponatremia (odds ratio [OR] = 2.91, 95 % CI [2.53, 3.35]). Patients age 18–64 and aged ≥ 65 with preoperative hyponatremia also demonstrated increased odds of a complicated appendicitis diagnosis, but to a lesser extent (OR = 2.11, 95 % CI [1.92, 2.32] (OR = 1.49, 95 % CI [1.25, 1.77], respectively). In a large analysis of matched patients with acute appendicitis, we found an association between immediate preoperative hyponatremia and complicated appendicitis. Future studies are indicated to further evaluate the role of hyponatremia as a potential diagnostic marker for complicated appendicitis in all age groups. This study suggests a role of hyponatremia as one of multiple variables to incorporate into future clinical decision tools for complicated acute appendicitis. Increased odds of complicated appendicitis with preoperative hyponatremia Greatest effect observed in pediatric appendicitis patients with hyponatremia Older adults had lowest odds of complicated appendicitis among all age groups. Uncomplicated appendicitis less common in patients with preoperative hyponatremia
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影响因子：
3.6
作者：
Bonadio, William;Rebillot, Katie;Iskhakov, Arthur
通讯作者：
Iskhakov, Arthur
影响因子：
2.4
作者：
Hu, Andrew;Chaudhury, Azraa S.;Raval, Mehul, V
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影响因子：
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作者：
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通讯作者：
Davidson, Giana H.
影响因子：
3.2
作者：
Leite, Rodrigo Moises de Almeida;de Souza, Alexandre Venancio;Ricciardi, Rocco
通讯作者：
Ricciardi, Rocco
影响因子：
3.8
作者：
Childers, Christopher P.;Dworsky, Jill Q.;Russell, Marcia M.
通讯作者：
Russell, Marcia M.