Analysis of Risk Factors for Recurrence Following Conservative Treatment of Acute Appendicitis-Related Abscesses in Children

Abstract

Background: Acute appendicitis accompanied by a periappendiceal abscess is a common pediatric surgical emergency, with a risk of recurrence. Objectives: To analyze the risk factors for the recurrence of acute appendicitis-related periappendiceal abscesses in children following the resolution of clinical symptoms. Methods: We retrospectively collected data from children admitted to the hospital with periappendiceal abscesses between 1 January 2015 and 31 December 2021. These children were categorized into recurrent and non-recurrent groups based on whether a periappendiceal abscess recurred. Gender, age, length of hospitalization, white blood cell (WBC) count, and C-reactive protein (CRP) levels at admission and discharge were compared between the two groups. Logistic regression was used to analyze the risk factors for the recurrence of periappendiceal abscesses in children following conservative treatment. Results: After 2 years of outpatient follow-up, 65 children were included in the study, nine of whom experienced recurrence. Significant differences were observed between the recurrent and non-recurrent groups in terms of abscess size at discharge (6.50 vs. 2.80 cm, P = 0.022), WBC count at discharge (13.25 × 10⁹/L vs. 6.98 × 10⁹/L, P = 0.016), and CRP level at discharge (32.80 vs. 8.60 mg/L, P = 0.002). A multifactorial logistic regression analysis indicated that both WBC count and CRP level at discharge were independently associated with the recurrence of periappendiceal abscesses. Conclusions: Increased attention should be given to the risk of recurrence in pediatric patients with elevated WBC counts and CRP levels at the time of discharge.