Negative appendectomy: a 10-year review of a nationally representative sample

Area of Science:

• General Surgery
• Surgical Outcomes
• Diagnostic Accuracy

Background:

• Appendectomy is a frequent emergency surgical procedure in the US.
• Negative appendectomies present challenges due to associated risks and costs.
• This study examines trends in negative appendectomy rates.

Purpose of the Study:

• To analyze current statistics and trends in negative appendectomy rates in the United States.
• To identify common misdiagnoses for appendicitis in men and women.

Main Methods:

• Retrospective analysis of the National Inpatient Sample (1998-2007).
• Included adult patients undergoing appendectomy, excluding incidental cases and those with appendiceal pathology.
• Stratified patients by sex and age to identify primary diagnoses mistaken for appendiceal disease.

Main Results:

• Negative appendectomy rates declined from 14.7% in 1998 to 8.47% in 2007.
• Women comprised 71.6% of negative appendectomies; ovarian cysts and malignant ovarian disease were common misdiagnoses.
• Diverticulitis was the most frequent misdiagnosis in men.

Conclusions:

• A consistent decrease in negative appendectomy rates was observed.
• Improved diagnostic techniques are likely contributing to this decline.
• Ovarian conditions are frequently misdiagnosed as appendicitis in women.