Negative appendectomy rate in patients diagnosed with acute appendicitis

Area of Science:

• Surgical outcomes research
• Abdominal surgery
• Diagnostic accuracy in emergency medicine

Background:

• Acute appendicitis is a leading cause of emergency department visits for acute lower abdominal pain.
• Determining the negative appendectomy rate is crucial for assessing diagnostic and surgical accuracy.

Purpose of the Study:

• To evaluate the negative appendectomy rate in patients diagnosed with acute appendicitis between 2015 and 2019.
• To identify patient and diagnostic factors associated with negative appendectomies.

Main Methods:

• Retrospective cohort study of 892 patients who underwent appendectomy for suspected acute appendicitis.
• Negative appendectomy defined by final pathology showing normal, congested, or inflamed appendix without acute appendicitis.

Main Results:

• The overall negative appendectomy rate was 8.6% (77/892).
• Higher rates were observed in females (70% of negative appendectomies), patients ≤40 years old, and those without diarrhea.
• Lower rates were associated with elevated white blood cell counts, increased neutrophils, and positive findings on abdominal ultrasonography or CT scans.

Conclusions:

• The negative appendectomy rate was below 10%, indicating good overall diagnostic accuracy.
• Factors like female sex, younger age, and absence of diarrhea correlated with increased negative appendectomies.
• Leukocytosis, neutrophilia, and positive imaging results significantly reduced negative appendectomy rates, underscoring the value of diagnostic imaging.