Predictive model for identification of gangrenous or perforated appendicitis in adults: a multicenter retrospective study.

BACKGROUND: Gangrene and perforation are severe complications of acute appendicitis, associated with a higher mortality rate compared to uncomplicated appendicitis. Accurate preoperative identification of Gangrenous or perforated appendicitis (GPA) is crucial for timely surgical intervention. METHODS: This retrospective multicenter study includes 796 patients who underwent appendectomy. Univariate and multivariate logistic regression analyses are used to develop a nomogram model for predicting GPA based on laboratory tests and computed tomography (CT) findings. The model is validated using an external dataset. RESULTS: Seven independent predictors were included in the nomogram: white blood cell count, lymphocyte count, D-dimer, serum glucose, albumin, maximum outer diameter of the appendix, and presence of appendiceal fecalith. The nomogram achieved good discrimination and calibration in both the training and testing sets. In the training set, the AUC was 0.806 (95%CI: 0.763-0.849), and the sensitivity and specificity were 82.1% and 66.9%, respectively. The Hosmer-Lemeshow test showed good calibration (P = 0.7378). In the testing set, the AUC was 0.799 (95%CI: 0.741-0.856), and the sensitivity and specificity were 70.5% and 75.3%, respectively. Decision curve analysis (DCA) confirmed the clinical utility of the nomogram. CONCLUSION: The laboratory test-CT nomogram model can effectively identify GPA patients, aiding in surgical decision-making and improving patient outcomes.

Associated Behavioral Factors and Prevalence of the Common Anorectal Disease Among Uyghur Male Adults of China: A Population-Based Crosssectional Study.

Objectives: We investigated the behavioral associated factors and prevalence of common anorectal disease (hemorrhoids, perianal pruritus, anal fistula, and others) among Uyghur male adults in southern Xinjiang. Methods: We conducted a cross-sectional study with a random sampling method from December 2020 to March 2021. Uyghur males aged 18 years and older were selected from Kashgar Prefecture in Xinjiang. The prevalence was evaluated by a bilingual questionnaire (including socio- demographic information, dietary habit, lifestyle, and behavioral habits) and anorectal examinations. The chi-square test was used for categorical variables. Logistic regression analysis was used to identify potential associated factors.Results: A total of 402 Uygur males aged ≥ 18 years were included in the final analysis. Of those, 192 (47.8%) participants were identified with common anorectal disease (CAD). Older age, lower education attainment, being a farmer, having lower personal annual income, having a high level of alcohol consumption, performing less anus-rinsing after defecation, and having less pubic hair removal were significantly associated with CAD. Conclusions: Common anorectal disease is a significant public health concern for the Uygur male population. Anus-rinsing after defecation and pubic hair removal are ethnic-specific behaviors among Uygur and could be preventive strategies for CAD.