Acute appendicitis---a recent audit of an old problem

Area of Science:

• Surgery
• Gastroenterology
• Public Health

Background:

• Appendicitis remains a common surgical emergency requiring accurate diagnosis.
• Diagnostic challenges in appendicitis can lead to delayed treatment or unnecessary surgery.
• Assessing diagnostic accuracy and patient outcomes is crucial for improving surgical care.

Purpose of the Study:

• To evaluate the diagnostic accuracy of appendicectomy.
• To identify factors influencing diagnostic accuracy, particularly in female patients.
• To compare outcomes based on timing of surgery and appendicitis complication status.

Main Methods:

• Retrospective review of appendicectomy cases at Queen Elizabeth Hospital, Hong Kong (1993-1994).
• Analysis of diagnostic accuracy for true appendicitis.
• Comparison of diagnostic accuracy and morbidity rates between genders, age groups, and surgical timing.

Main Results:

• Overall diagnostic accuracy for appendicitis was 74%.
• Diagnostic accuracy was significantly lower in female patients (66%) compared to males (82%), particularly in those aged 15-40 years (62%).
• Complicated appendicitis (21% morbidity) had higher morbidity than uncomplicated cases (9%). No significant difference in outcomes was found based on surgical timing (same day vs. next day admission).

Conclusions:

• Appendicectomy diagnostic accuracy requires improvement, especially for female patients aged 15-40.
• While overall morbidity and mortality rates were acceptable, complicated appendicitis poses a higher risk.
• The timing of surgery (same day vs. next day) did not significantly impact diagnostic accuracy or morbidity.