Treatment outcomes of acute appendicitis and associated factors among admitted patients with a diagnosis of acute abdomen in Debre Markos Referral Hospital, Amhara Region, North West Ethiopia

Abstract

<jats:sec><jats:title>Introduction</jats:title><jats:p> Appendicitis is an inflammation of the vermiform appendix and is one of the most common causes of an acute abdomen in young adults. If left untreated, it can lead to appendiceal abscess, perforation and peritonitis. </jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p> To assess treatment outcomes of acute appendicitis and associated factors among admitted patients with a diagnosis of acute abdomen. Methods and materials: A cross sectional study was employed among 169 patients using a census. Data were collected from patient medical records by using a checklist. Data were entered using Epi-data and analysed by statistical product and service solution. Logistic regression analysis was employed. </jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p> Among 303 patients with a diagnosis of acute abdomen, 169 (55.7%) developed acute appendicitis; of whom, 45 (26.6%) developed unfavourable treatment outcomes. Patients who had elevated white blood cell count at the time of presentation (adjusted odds ratio = 4.7; 95% confidence interval (1.95, 11.35)) and intraoperative appendiceal abscess (adjusted odds ratio = 3.8; 95% confidence interval (1.61, 9.07)) were significantly associated with an unfavourable appendicitis treatment outcome. Conclusion and recommendation: Nearly a quarter of the patients developed unfavourable treatment outcomes. Elevated white blood cell count and intraoperative appendiceal abscess were significantly associated with unfavourable appendicitis treatment outcome. Therefore, early detection and treatment of appendiceal abscess is crucial for a better outcome. </jats:p></jats:sec>

Prevalence of Postoperative Unfavorable Outcome and Associated Factors in Patients with Appendicitis: A Cross-Sectional Study

“…Lastly, the investigators confirmed that age was not an independent predictor of post-operation unfavorable outcomes of appendectomy. This result has disagreements with the previous studies 15 , 17 , 42 in which elderly patients are more at risk to develop post-operation negative outcomes. This disagreement may be due to the study period and socio-demographic variations of the studies.…”

“…8–11 In the last few decades, in African countries, appendicitis frequency is increasingly noted. 12–14 In Ethiopia, the incidence is increasing through time such as in Debre Markos Referral Hospital (26.6%), 15 as stated by Mohammed S et al a studies in 2014 by Nebyou S et al (28%), in 2019 by Wosen MT (55.4%), 16 and 36 deaths in Gondar University Hospital. 17…”

Factors Contributing to Delays to Accessing Appendectomy in Low‐ and Middle‐Income Countries: A Scoping Review

“…All the studies were quantitative. The most common study designs were cross‐sectional 38 (48.7%) [14–52] and cohort 32 (41.0%) [26, 52–83] (Table 1). Study periods ranged from two months to twenty‐five years.…”

“…Study periods ranged from two months to twenty‐five years. There were 27 097 patients across the seventy‐eight studies with a median of 166 (IQR: 10–3717) [14–28, 30, 32–42, 44–61, 63, 64, 66–82, 84–92].…”

“…In addition, fifty-five studies reported mortality rates. Of these studies, 141 (0.8%) appendicitis patients died [14][15][16]18…”