An Analysis of Factors that Predict Hospital Readmission after Surgery for Perforated Appendicitis

2017 ◽  
Vol 83 (9) ◽  
pp. 991-995 ◽  
Author(s):  
Jeffanne E. Millien ◽  
Michael Townsend ◽  
Joshua Goldberg ◽  
George M. Fuhrman
Keyword(s):  
Hospital Readmission ◽  
Open Surgery ◽  
Demographic Data ◽  
Vital Signs ◽  
Perforated Appendicitis ◽  
Laboratory Findings ◽  
Percutaneous Abscess Drainage ◽  
Increased Risk ◽  
Perforated Appendix ◽  
Clinically Significant

We performed this study to develop an understanding of why patients were readmitted after appendectomy for perforated appendicitis. Patients who required surgery for perforated appendicitis during a recent five-year period were identified. We recorded the demographic data, length of symptoms, length of stay, vital signs, laboratory findings, surgical approach, length of surgery, time to readmission, length of readmission, and intervention required after readmission. We divided the cohort into two groups depending on whether the patient was readmitted. We used chisquared analysis and t test to determine differences between the two groups. We identified 86 patients, with 14 (16.3%) requiring readmission. The only factors that predicted readmission were longer appendectomy surgery (P = 0.03) and open surgery (P = 0.04). After readmission, one patient required reoperation, and two required percutaneous abscess drainage. The remaining 11 patients were readmitted for a median of two days, received intravenous fluids, and required no additional clinically significant management. Patients requiring longer and open surgery are at an increased risk for hospital readmission after resection of a perforated appendix. Efforts to reduce readmission will likely be most successful if hydration and brief periods of clinical observation can be arranged when necessary for patients after discharge from surgery.

Is age an independent predictor of clincially significant prostate cancer in a referral population? A case for needle biopsy in the elderly

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 5142-5142
Author(s):  
G. Hanson ◽  
J. Wright ◽  
J. Kim ◽  
L. S. Borden ◽  
C. R. Porter
Keyword(s):  
Prostate Cancer ◽  
Life Expectancy ◽  
Needle Biopsy ◽  
Independent Predictor ◽  
Demographic Data ◽  
Age Groups ◽  
The Elderly ◽  
Prostate Needle Biopsy ◽  
Increased Risk ◽  
Clinically Significant

5142 Background: Approximately 232,090 new cases of prostate cancer were diagnosed in the U.S. in 2005. As the population ages and life expectancy increases, physicians will increasingly be faced with patients in their 70’s who can be expected to live for greater than 10 years. Many of these patients are screened for prostate cancer and may ultimately be evaluated by a urologist. Clinically significant prostate cancer is still diagnosed in men in this age group. To address this issue, we evaluated a large prostate biopsy database to assess the nature of prostate cancer diagnosed in elderly men in a referral population. Methods: A prospective database of 790 men who had undergone biopsy by a single urologist (CRP) was reviewed. Demographic data was recorded. Patients with Gleason score 7–10 were defined as having clinically significant disease. Multivariate regression analysis was performed to determine the relationship of increasing age with higher Gleason scores (7–10) on biopsy. We divided our patients into clinically applicable age groups of greater than or equal to 70 and less than 70 years. Results: The mean age of patients was 63.1 years. Men over 70 years old were more likely to have increased mean prostatic volume (P < 0.001), abnormal DRE (P < 0.001) and presence of prostate cancer (P < 0.001). Patients aged 70 or older had more than a three-fold increased risk of Gleason 7 or greater cancer (OR 3.32, p <0.001). An abnormal DRE (OR 3.65, p<0.001) and PSA >10 (OR 4.05, p <0.001) were also independently associated with a statistically significant chance of detecting Gleason 7 or greater cancer. Conclusions: Age is an independent predictor of clinically significant prostate cancer in a referral population. Patients who are 70 years or older with a 10-year life expectancy should be counseled that they are at higher risk of harboring clinically significant prostate cancer and should therefore be considered for prostate needle biopsy. [Table: see text] No significant financial relationships to disclose.

Sym001, the First Recombinant Polyclonal Rhesus-D Specific Antibody Product, Was Safe and Well-Tolerated in a Placebo-Controlled Randomized Phase I Trial.

Blood ◽  
2008 ◽  
Vol 112 (11) ◽  
pp. 1987-1987
Author(s):  
Peter Hjelmström ◽  
Bengt Hallén ◽  
Ewa Lindenstroem ◽  
Shwe Gyaw
Keyword(s):  
Clinical Chemistry ◽  
Vital Signs ◽  
Primary Objective ◽  
Serious Adverse Events ◽  
Laboratory Findings ◽  
New Class ◽  
Severe Intensity ◽  
Clinically Significant ◽  
To Receive ◽  
Dose Dependent

Abstract Sym001 is the first compound in a new class of biopharmaceuticals in clinical development for the treatment of Immune Thrombocytopenic Purpura (ITP), and the prevention of hemolytic disease of the newborn by anti-D prophylaxis (ADP). Sym001 is a recombinant polyclonal antibody product consisting of 25 different anti-Rhesus D specific (RhD) antibodies. The primary objective of this clinical study was to assess the safety of Sym001 following a single intravenous (iv) dose in RhD+ and RhD− healthy male volunteers. Secondary objectives were to assess the potential immunogenicity and pharmacokinetic (PK) profile of Sym001. Fifty-nine RhD+ subjects and 18 RhD− subjects were randomized to receive up to 12.5 μg/kg or 75 μg/kg, respectively, in seven dose cohorts as shown below: Number of Subjects Cohort Dose (μg/kg) RhD+ Sym001 RhD+ Placebo RhD− Sym001 RhD− Placebo 1 0.25 5 2 0 0 2 1.0 5 2 0 0 3 4.0 7 2 7 2 4 12.5 7 2 7 2 5 25 7 2 0 0 6 50 7 2 0 0 7 75 7 2 0 0 Treatment with Sym001 was well tolerated and there were no serious adverse events (SAEs), no AEs of severe intensity and no AEs that resulted in discontinuation of the study in either the RhD+ or RhD− population. The frequencies of treatment-emergent AEs (TEAE), i.e. AEs occurring after drug administration, were similar among Sym001 and placebo treated subjects and there was no dose-dependent pattern of TEAEs. No significant decrease in mean hemoglobin level compared to baseline was observed at any dose level during the study, and no decrease in hemoglobin &gt; 2 g/dL in any subject was seen. No other laboratory findings were suggestive of clinically significant hemolysis. In addition, no clinically significant changes in vital signs or electrocardiograms (ECGs) were observed, and there were no significant changes in clinical chemistry variables that did translate into SAEs or were assessed as being related to study medication. No immunogenicity to Sym001 was detected and analysis of PK is in progress. In conclusion, Sym001 was found to be safe and well-tolerated in healthy volunteers in doses up to 75 μg/ kg. Sym001 is now being evaluated in a red blood cell (RBC) challenge trial for the ADP indication and in a Phase II trial for treatment of patients with ITP.

Association of interval appendectomy with risk of neoplasm.

2012 ◽  
Vol 30 (4_suppl) ◽  
pp. 430-430 ◽  
Author(s):  
Matthew Jason Furman ◽  
Mitchell Cahan ◽  
Philip Cohen ◽  
Giles Francis Whalen ◽  
Laura A. Lambert
Keyword(s):  
Demographic Data ◽  
Tertiary Care ◽  
Perforated Appendicitis ◽  
Interval Appendectomy ◽  
Resection Rate ◽  
Increased Risk ◽  
Mucinous Neoplasms ◽  
Tertiary Care Institution ◽  
The Mean

430 Background: The role of interval appendectomy after conservative management of perforated appendicitis remains controversial. Determining the etiology of perforated appendicitis is one reason to perform interval appendectomies. This study hypothesizes that there is an increased rate of neoplasm in patients undergoing interval appendectomy. Methods: This is a retrospective review of all patients over 18 years of age who underwent appendectomy for presumed appendicitis from January, 2006 to December, 2010 at a single, tertiary care institution. Demographic data, pathologic diagnosis, clinico-pathologic characteristics, interval resection rate, and complication data were collected and analyzed. Results: During the study period, 376 patients underwent appendectomy. The mean age was 41 years (range 18 to 94). Interval appendectomy was performed in 18 patients (5.0%) (age 28 to 74). Neoplasms were identified in 14 patients (3.7 %); 6 were found in patients who had undergone interval appendectomy (33%). Nine were mucinous tumors (69.2%), 5 of which were associated with interval appendectomies. Neoplasms were identified in 8.3% of patients between 35 and 55 years old. Conclusions: Mucinous neoplasms of the appendix were found in 33% of patients undergoing interval appendectomy. Interval appendectomies should be considered in all patients 35 years and older due to increased risk of appendiceal neoplasm. [Table: see text]

Appendectomy: Should it be Performed So Quickly?

2016 ◽  
Vol 82 (1) ◽  
pp. 65-74 ◽  
Author(s):  
Byeong Geon Jeon ◽  
Hyuk Jung Kim ◽  
Kuk Hyun Jung ◽  
Hye In Lim ◽  
Sang Wook Kim ◽  
...  
Keyword(s):  
Symptom Onset ◽  
Postoperative Ileus ◽  
Demographic Data ◽  
Perforated Appendicitis ◽  
Postoperative Outcomes ◽  
Time Interval ◽  
Hospital Arrival ◽  
Suspected Appendicitis ◽  
Abdominal Abscesses ◽  
Increased Risk

Controversy surrounds appendectomy timings and their effects on postoperative outcomes. This study evaluated the influence of hospital delays on perforation rates and complications in patients with acute appendicitis. From January 2008 to December 2013, the cases of 4148 consecutive patients who had undergone appendectomies for suspected appendicitis were reviewed. The patients’ demographic data, times from symptom onset to hospital arrival (prehospital delay), times from hospital arrival to surgery (hospital delay), histological findings, and postoperative outcomes were documented. Perforation rates and complications were assessed at each time interval between symptom onset and surgery. Perforation rates and complications increased with longer prehospital delays, but no correlations were evident between hospital delays and perforation rates or between hospital delays and complications. Although delaying appendectomies for >18 hours had no statistically significant impact on perforation rates (25.3 vs 19.4%, P = 0.133), it caused more complications (8.7 vs 3.8%, P = 0.023) compared with cases delayed for 12 to 18 hours. Multivariate analyses determined that hospital delays were not associated with increased risks of perforation, complications, wound infections, or intra-abdominal abscesses. However, a >18-hour hospital delay was associated with a significantly increased risk of postoperative ileus (odds ratio = 2.94, 95% confidence interval = 1.17–7.41, P = 0.022). Hospital delays were not associated with significantly increased risks of perforation and complications. However, patients with perforated appendicitis had higher risks of developing postoperative ileus if hospital delays were >18 hours. Therefore, hospital delays of ≤18 hours are safe, but caution is required if delays are >18 hours.

scholarly journals Predictive modeling for peri-implantitis by using machine learning techniques

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Tomoaki Mameno ◽  
Masahiro Wada ◽  
Kazunori Nozaki ◽  
Toshihito Takahashi ◽  
Yoshitaka Tsujioka ◽  
...  
Keyword(s):  
Machine Learning ◽  
Demographic Data ◽  
Risk Indicators ◽  
Machine Learning Techniques ◽  
Support Vector ◽  
Machine Learning Methods ◽  
Complex Interactions ◽  
Learning Techniques ◽  
Increased Risk ◽  
Vector Machines

AbstractThe purpose of this retrospective cohort study was to create a model for predicting the onset of peri-implantitis by using machine learning methods and to clarify interactions between risk indicators. This study evaluated 254 implants, 127 with and 127 without peri-implantitis, from among 1408 implants with at least 4 years in function. Demographic data and parameters known to be risk factors for the development of peri-implantitis were analyzed with three models: logistic regression, support vector machines, and random forests (RF). As the results, RF had the highest performance in predicting the onset of peri-implantitis (AUC: 0.71, accuracy: 0.70, precision: 0.72, recall: 0.66, and f1-score: 0.69). The factor that had the most influence on prediction was implant functional time, followed by oral hygiene. In addition, PCR of more than 50% to 60%, smoking more than 3 cigarettes/day, KMW less than 2 mm, and the presence of less than two occlusal supports tended to be associated with an increased risk of peri-implantitis. Moreover, these risk indicators were not independent and had complex effects on each other. The results of this study suggest that peri-implantitis onset was predicted in 70% of cases, by RF which allows consideration of nonlinear relational data with complex interactions.

scholarly journals 270. Clinical Outcomes of Ceftriaxone versus Penicillin G for Complicated Viridans Group Streptococci Bacteremia

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S137-S137
Author(s):  
Stephanie Wo ◽  
Yanina Dubrovskaya ◽  
Justin Siegfried ◽  
John Papadopoulos ◽  
Shin-Pung Jen
Keyword(s):  
Clinical Outcomes ◽  
Hospital Readmission ◽  
Protective Factor ◽  
Primary Outcome ◽  
Bloodstream Infections ◽  
Penicillin G ◽  
Eligibility Criteria ◽  
Extended Spectrum Beta Lactamase ◽  
Increased Risk ◽  
Viridans Group Streptococci

Abstract Background Viridans group streptococci (VGS) is an infrequent yet significant cause of bloodstream infections, and complicated cases may require prolonged antibiotic therapy. Ceftriaxone (CTX) and penicillin G (PCN G) are both considered first line options for VGS infections, but comparisons between these agents are limited. We evaluated the clinical outcomes amongst patients treated with CTX and PCN G for complicated VGS bacteremia. Methods This was a single-center, retrospective study of adult patients with ≥1 positive VGS blood culture who were treated with either CTX or PCN G/ampicillin (both included in PCN G arm) between January 2013 and June 2019. The primary outcome was a composite of safety endpoints, including hospital readmission due to VGS or an adverse event (AE) from therapy, Clostridioides difficile infections, treatment modification or discontinuation due to an antibiotic-related AE, and development of extended-spectrum beta lactamase resistance. Secondary outcomes included the individual safety endpoints, VGS bacteremia recurrence, hospital readmission, and all-cause mortality. Results Of 328 patients screened for inclusion, 94 patients met eligibility criteria (CTX n= 64, PCN G n=34). Median age was 68 years (IQR 56–81) and 68% were male. Study patients did not present with critical illness, as reflected by a median Pitt bacteremia score of 0 in the CTX and 1 in the PCN G arms, P=0.764. Streptococcus mitis was the most common VGS isolate and infective endocarditis (IE) was the predominant source of infection. CTX was not significantly associated with increased risk of the primary outcome (14% vs. 27%; P= 0.139). The driver of the composite outcome was hospital readmission due to VGS bacteremia or therapy complications. Results were similar in the subgroup of patients with IE (12.5% vs. 23.5%). No secondary endpoints differed significantly between groups. On multivariate analysis, source removal was a protective factor of the primary outcome (OR 0.1; 95% CI 0.020–0.6771; P= 0.017). Conclusion Despite potential safety concerns with the prolonged use of CTX in complicated VGS bacteremia, this study did not demonstrate a higher rate of treatment failure, adverse events, or resistance. These findings warrant further exploration. Disclosures All Authors: No reported disclosures

scholarly journals AB0473 “HALO SIGN” IN ULTRASOUND OF TEMPORAL, FACIAL AND AXILLARY ARTERIES: ASSOCIATIONS WITH CLINICAL SYMPTOMATOLOGY AND LABORATORY FINDINGS

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1534.2-1535
Author(s):  
G. Evangelatos ◽  
G. E. Fragoulis ◽  
A. Iliopoulos
Keyword(s):  
Vessel Wall ◽  
Vascular Inflammation ◽  
Inflammation Markers ◽  
Laboratory Findings ◽  
Clinical Symptomatology ◽  
Temporal Arteries ◽  
Halo Sign ◽  
Increased Risk ◽  
Us Findings ◽  
Specific Symptoms

Background:Giant cell arteritis (GCA) has two subtypes, the cranial form (“cranial GCA”) and the large-vessel form (“LV-GCA”). GCA can present with “cranial” symptoms (headache, visual symptoms, jaw claudication, scalp tenderness), constitutional symptoms (fever, fatigue), limb claudication and symptoms of polymyalgia rheumatica (PMR) and usually causes increased inflammation markers, anemia and thrombocytosis. Ultrasound (US) of the temporal and axillary arteries has a well-established role in cranial GCA and LV-GCA diagnosis, respectively. However, it is unknown whether specific clinical and laboratory parameters are linked with US findings suggestive of vascular inflammation (“halo” sign).Objectives:The aim of this study was to examine possible association between clinical and laboratory characteristics of the patients and detection of vessel wall inflammation in the US.Methods:Patients ≥50 years old with elevated ESR (≥50mm/h) and/or CRP (≥10mg/L) that presented in our outpatient rheumatology clinics from July 2017 to December 2019 with possible clinical diagnosis of GCA were included. Three groups were compared: Patients with “cranial symptoms” (with or without PMR), patients with PMR symptoms only and patients with increased inflammation markers without specific symptoms indicative of GCA. Temporal arteries and their main branches, as well as facial and axillary arteries were evaluated by US bilaterally for the presence of non-compressible “halo sign” at the vessel wall. Clinical symptomatology and the occurrence of anemia and thrombocytosis were recorded.Results:52 patients were included. 71.2% were females, with a mean±SD age of 71.0±10.0 years. 17 patients had “cranial symptoms” (seven patients with concomitant PMR and ten without), 17 patients had PMR symptoms only, while 18 patients had non-specific symptoms (e.g. fever) (Table 1). Among 17 patients with “cranial symptoms”, 7/7 (100%) with concomitant PMR had a positive temporal US, while only 3 out of 10 (30%) without PMR had a positive temporal US (p<0.01) and US was indeterminate in 2 of them (20%). Collectively, 10/17 (58.8%) of patients with “cranial symptoms” and systemic inflammation had a US examination compatible with GCA. No patient with “cranial symptoms” had a positive US of axillary arteries. No patient with only PMR symptoms, had “halo sign” in temporal and facial arteries, while 3 out of 17 (17.6%) had a positive axillary US. From the 18 patients with elevated ESR/CRP, one had a positive temporal US and another one had a positive axillary US. Regarding specific symptoms, positive temporal US was associated with new headache (p=0.003), vision impairment (p=0.001), jaw claudication (p=0.05), scalp tenderness (p=0.01) and fever (P=0.002), but not with PMR (p=0.317). Thrombocytosis was associated with an increased risk for “halo sign” detection in temporal (p=0.04) and facial (p=0.007) arteries, but not in axilliary arteries (p=0.52).Conclusion:60% of patients with “cranial symptoms” and elevated inflammation markers have US temporal findings indicative of GCA. This is more pronounced in patients with concomitant PMR symptoms and is associated with specific symptomatology. 18% of patients with only PMR symptoms might have LV-GCA, while those with high ESR/CRP without GCA-related symptoms rarely have “halo sign” in US.Disclosure of Interests:None declared

scholarly journals Observational study of thrombosis and bleeding in COVID-19 VV ECMO patients

2021 ◽  
pp. 039139882198906
Author(s):  
Brianda Ripoll ◽  
Antonio Rubino ◽  
Martin Besser ◽  
Chinmay Patvardhan ◽  
William Thomas ◽  
...  
Keyword(s):  
Intensive Care ◽  
Ct Scan ◽  
Thrombotic Event ◽  
Area Under The Curve ◽  
Whole Body ◽  
Bleeding Events ◽  
Heparin Resistance ◽  
Increased Risk ◽  
Thrombotic Complications ◽  
Clinically Significant

Introduction: COVID-19 has been associated with increased risk of thrombosis, heparin resistance and coagulopathy in critically ill patients admitted to intensive care. We report the incidence of thrombotic and bleeding events in a single center cohort of 30 consecutive patients with COVID-19 supported by veno-venous extracorporeal oxygenation (ECMO) and who had a whole body Computed Tomography Scanner (CT) on admission. Methodology: All patients were initially admitted to other hospitals and later assessed and retrieved by our ECMO team. ECMO was initiated in the referral center and all patients admitted through our CT scan before settling in our intensive care unit. Clinical management was guided by our institutional ECMO guidelines, established since 2011 and applied to at least 40 patients every year. Results: We diagnosed a thrombotic event in 13 patients on the initial CT scan. Two of these 13 patients subsequently developed further thrombotic complications. Five of those 13 patients had a subsequent clinically significant major bleeding. In addition, two patients presented with isolated intracranial bleeds. Of the 11 patients who did not have baseline thrombotic events, one had a subsequent oropharyngeal hemorrhage. When analyzed by ROC analysis, the area under the curve for % time in intended anticoagulation range did not predict thrombosis or bleeding during the ECMO run (0.36 (95% CI 0.10–0.62); and 0.51 (95% CI 0.25–0.78); respectively). Conclusion: We observed a high prevalence of VTE and a significant number of hemorrhages in these severely ill patients with COVID-19 requiring veno-venous ECMO support.

scholarly journals Mediterranean Diet and Lifestyle Habits during Pregnancy: Is There an Association with Small for Gestational Age Infants? An Italian Single Centre Experience

Nutrients ◽  
2021 ◽  
Vol 13 (6) ◽  
pp. 1941
Author(s):  
Rachele De Giuseppe ◽  
Manuela Bocchi ◽  
Silvia Maffoni ◽  
Elsa Del Bo ◽  
Federica Manzoni ◽  
...  
Keyword(s):  
Gestational Diabetes ◽  
Mediterranean Diet ◽  
Gestational Age ◽  
Small For Gestational Age ◽  
Small Sample Size ◽  
Demographic Data ◽  
Small Sample ◽  
Activity Level ◽  
Lifestyle Habits ◽  
Increased Risk

Background. The small-for-gestational-age (SGA) in infants is related to an increased risk of developing Non-Communicable Diseases later in life. The Mediterranean diet (MD) is related to lower odds of being SGA. The study explored retrospectively the association between SGA, maternal MD adherence, lifestyle habits and other SGA risk factors during pregnancy. Methods. One hundred women (16–44 years) with a pregnancy at term were enrolled. Demographic data, parity, pre-gestational BMI, gestational weight gain, pregnancy-related diseases, and type of delivery were collected. The MD adherence (MEDI-LITE score ≥ 9), physical activity level, and smoking/alcohol consumption were registered. SGA neonates were diagnosed according to the neonatal growth curves. Results. Women were divided into “SGA group” vs. “non-SGA group”. The MD was adopted by 71% of women and its adherence was higher in the “non-SGA group” (p = 0.02). The prevalence of pregnancy-related diseases (gestational diabetes/pregnancy-induced hypertension) was higher in the “SGA group” (p = 0.01). The logistic regression showed that pregnancy-related diseases were the only independent risk factor for SGA. Conclusions. MD may indirectly reduce the risk of SGA since it prevents and exerts a positive effect on pregnancy-related diseases (e.g., gestational diabetes and hypertension). The small sample size of women in the SGA group of the study imposes a major limitation to the results and conclusions of this research, suggesting however that it is worthy of further investigation.

Upgrade rates and outcomes of screen-detected atypical intraductal epithelial proliferation (AIDEP) diagnosed on core needle biopsy

2021 ◽  
pp. 1-6
Author(s):  
Emma C. Dunne ◽  
Edel M. Quinn ◽  
Maurice Stokes ◽  
John M. Barry ◽  
Malcolm Kell ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Core Needle Biopsy ◽  
Needle Biopsy ◽  
Demographic Data ◽  
Screening Mammography ◽  
Published Data ◽  
Epithelial Proliferation ◽  
Core Needle ◽  
In Situ Carcinoma ◽  
Increased Risk

INTRODUCTION: Atypical intraductal epithelial proliferation (AIDEP) is a breast lesion categorised as “indeterminate” if identified on core needle biopsy (CNB). The rate at which these lesions are upgraded following diagnostic excision varies in the literature. Women diagnosed with AIDEP are thought to be at increased risk of breast cancer. Our aim was to identify the rate of upgrade to invasive or in situ carcinoma in a group of patients diagnosed with AIDEP on screening mammography and to quantify their risk of subsequent breast cancer. METHODS: We conducted a retrospective review of a prospectively maintained database containing all patients diagnosed with AIDEP on CNB between 2005 and 2012 in an Irish breast screening centre. Basic demographic data was collected along with details of the original CNB result, rate of upgrade to carcinoma and details of any subsequent cancer diagnoses. RESULTS: In total 113 patients were diagnosed with AIDEP on CNB during the study period. The upgrade rate on diagnostic excision was 28.3% (n = 32). 6.2% (n = 7) were upgraded to invasive cancer and 22.1% (n = 25) to DCIS. 81 patients were not upgraded on diagnostic excision and were offered 5 years of annual mammographic surveillance. 9.88% (8/81) of these patients went on to receive a subsequent diagnosis of malignancy. The mean time to diagnosis of these subsequent cancers was 65.41 months (range 20.18–145.21). CONCLUSION: Our data showing an upgrade rate of 28% to carcinoma reflects recently published data and we believe it supports the continued practice of excising AIDEP to exclude co-existing carcinoma.

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