Quick Literature Updates Ep 26

Recent literature has been supporting treating appendicitis with antibiotics rather than surgery

The Saint Peter et al. study was a multi-center randomized trial in Canada, the US, Finland, Sweden, and Singapore investigating whether antibiotic treatment is inferior to appendicectomy

34% of children treated with antibiotics for appendicitis eventually required surgery within a year compared to only 7% in the surgery group

There were no deaths in either the antibiotic or surgery group for appendicitis treatment

Children in the antibiotic group had a higher risk of mild to moderate adverse events compared to the surgery group

Antibiotics were not as effective as surgery for treating non-perforated appendicitis in children, as it did not meet the threshold for non-inferiority

Zoo et al. used the PHIS database and performed a multi-institutional cohort study of all ARM patients between 2016 and 2022

In ARM patients, the rates of actual diagnoses across all hospital encounters were 45.4% vertebral spinal, 77.4% cardiac, 10.2% TEF, 39.9% renal and 15.7% limb

25.8% of female patients with anorectal malformations had a congenital gynecologic malformation diagnosed

The most common anomalies associated with ARMs are cardiac, vertebrospinal, renal, and gynecologic

The authors of the ARM screening study suggest changing the VACTERL acronym to VACTERL-GS

The Schlapbach et al. study is a worldwide study with a Delphi consensus process that aimed to update the definitions of sepsis and septic shock

The Phoenix sepsis score includes variables in cardiovascular function, respiratory function, coagulation, and neurological function

The Phoenix sepsis score helped correlate the definition of sepsis with an actual mortality rate

The definition of sepsis is suspected infection plus 2 points in the Phoenix sepsis score

Septic shock is defined as sepsis plus cardiovascular dysfunction that is seen when there is 1 point in the cardiovascular variable of the Phoenix sepsis score

Sepsis has a mortality rate of 7.1%

Septic shock has a mortality rate of 10.8 to 33.5% according to the research settings