Risk Factors for Postoperative Infections Following Appendectomy of Complicated Appendicitis: A Meta-analysis and Retrospective Single-institutional Study

Katherine Cironi, Tulane University School of Medicine
Aaron L. Albuck, Tulane University School of Medicine
Bryant McLafferty, Tulane University School of Medicine
Alison K. Mortemore, Tulane University School of Medicine
Christina McCarthy, Tulane University School of Medicine
Mohammad Hussein, Tulane University School of Medicine
Peter P. Issa, LSU Health Sciences Center - New Orleans
Tyler Metz, Tulane University School of Medicine
Marcela Herrera, Tulane University School of Medicine
Eman Toraih, Suez Canal University Faculty of Medicine, Ismailia, Egypt
Sharven Taghavi, Tulane University School of Medicine
Emad Kandil, Tulane University School of Medicine
Jacquelyn Turner, Tulane University School of Medicine

Abstract

Patients with complicated appendicitis have an increased risk for postoperative infections. Potential risk factors for postoperative infections through a meta-analysis and retrospective chart review are discussed. A meta-analysis consisting of 35 studies analyzing complicated appendicitis treated with an appendectomy noting at least 1 postoperative infection was performed. A retrospective review was then conducted in patients diagnosed with complicated appendicitis after appendectomy. Of 5326 patients in total, 15.4% developed postoperative infections. Laparoscopic surgery and perioperative hyperoxygenation were found to be protective factors for the development of infection. Retrospectively, 53.2% of patients presented with complicated appendicitis. Patients with complicated appendicitis were more likely to be older in age and have an increased length of stay. Patient demographics, operative time, and comorbid status had no effect on postoperative infection or readmission rate. Physicians should strongly consider minimally invasive techniques to treat all cases of complicated appendicitis irrespective of comorbidities, age, sex, or body mass index.