Seasonal Variations and the Associated Factors of Acute Appendicitis at a Tertiary Hospital: A Case of SPHMMC, Addis Ababa, Ethiopia

Abstract

Background: Acute appendicitis, a surgical emergency, is a prevalent pathology with uncertain etiology, influenced by various factors and seasonal variations. Objective: To determine the seasonal variations and the associated factors of Acute Appendicitis. Methods: The study analyzed demographic features, seasonal variation, length of hospital stay, and surgical treatment outcomes in 384 patients from 2021-2022. The patients were presented in four different seasons; December-February as winter, March-May as autumn, June-August as summer, and September-Nov as spring, which were assessed to describe seasonal variation and compare to what are observed in other countries. SPSS version 28 was used for all the statistical assessments and analyses. Results: Out of all 384 patients, 64.3% were males and 35.7% were females. The mean age was 20.8, male: female, 1.8:1. The majority of patients were in their 2nd and 3rd decades of life, and more common in the male 10–19 age group (22.1%). 23.9% of cases were observed in autumn, 22.7% in winter, 20.6% in spring, and 32.8% in summer. 10.1% increase in summer as compared to winter, 8.9% increase as compared to autumn, and 12.2% increase as compared to spring. The highest admissions were in the summer (32.8%). July had the highest number of cases (12.5%), which coincided with heavy rainy months, the rainiest days, and the lowest sunlight hours. The highest rainfall was observed in July (386mm) and August (491 mm), and the lowest sunlight hours were observed in July (6.1 hours) and August (5.9 hours), respectively. Monthly cases correlated positively with rainfall (Pearson’s R =.637, p<.05) and negatively with sunlight hours (Pearson’s R = -.618, p<.05). Complicated cases were slightly more common (50.9%), more in the 10–19 age group. Males had more complicated cases (38.3%) than females (20.8%). Complicated cases tend to present after 48 hours. The commonest postoperative complication was wound infection (5.5%). The mean length of hospital stay was 2.47 days, with no death was reported in the study period. Conclusion: Peak appendicitis in summer is linked to rainfall and sunlight hours, affecting the 11-20 age groups.