48-Hour Symptom Onset Marks Elevated Risk for Perforated Appendicitis

A clinical risk model underscores that a 48-hour symptom threshold significantly predicts perforation in acute appendicitis. An analysis of 414 patients revealed that longer delays before hospital presentation correlate with increased perforation risk. Notably, time intervals over 48 hours yielded an adjusted odds ratio of 3.30 for perforation. Elevated CRP levels and the presence of appendicolith further enhance risk assessment. This model offers a critical tool for tailoring treatment strategies at hospital admission.