Is early analgesia associated with delayed treatment of appendicitis?
Received 28 February 2007; received in revised form 17 April 2007; accepted 18 April 2007.
Abstract
Purpose
We sought to investigate the relationship between delay in treatment of appendicitis and early use of analgesia.
Basic Procedures
We designed a matched case-control study, with patients having delayed treatment of appendicitis as the cases and patients with no delay in treatment of appendicitis as controls matched for age, sex, Alvarado score, and date of diagnosis. Of 957 patients with appendicitis, there were 103 delayed cases. Matching patients were identified yielding 103 controls.
Main Findings
In comparing cases and controls for early opiate use (26/103 cases, 24/103 controls), there was no association with delayed treatment (odds ratio, 1.11; P = .745; 95% confidence interval, 0.59-3.89). When comparing cases and controls for early NSAID use (29/103 cases, 17/103 controls), an association was found with delayed treatment (odds ratio, 1.98; P = .045; 95% confidence interval, 1.01-3.89).
Conclusion
For early analgesia in appendicitis, we did not find an association with delayed treatment for opiate analgesia, but there did appear to be an association with nonsteroidal anti-inflammatory analgesia.
aEmergency Department, Lehigh Valley Hospital - Muhlenberg, Bethlehem, PA 18017, USA
bEmergency Department, Danbury Hospital, Danbury, CT, formerly Emergency Medicine Residency, Lehigh Valley Hospital-Muhlenberg, Bethlehem, PA 18017, USA
cHealthcare Research, Lehigh Valley Hospital, Allentown, PA 18105, USA
dFormerly of Department of Health Studies, Lehigh Valley Hospital, Allentown, PA 18105, USA
Preliminary results of this study were presented at the Society for Academic Emergency Medicine Annual Meeting in New York City, NY, as an oral presentation on May 22, 2005.
ABSTRACT