Morbidity and Mortality Pattern of Appendicitis in Rural Teaching Hospital of Nepal (original) (raw)
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International Journal of Public Health Science (IJPHS), 2023
Appendicitis is one of the most common abdominal inflammations in daily emergency cases. The diagnosis of appendicitis is often delayed because the symptoms resemble other abdominal emergencies. The present research aimed to describe the clinical and epidemiological profile of acute appendicitis patients. The research design is a cohort retrospective study employing appendicitis patients' medical record data at PKU Muhammadiyah Hospital from January 1, 2016, to December 31, 2020. The variables obtained through the patient records were age, gender, domicile location, vital signs, physical examination, blood laboratory, ultrasound, histopathology, postoperative diagnosis, the incidence of peritonitis, and length of stay. The median age value in patients with appendicitis was 27 years (0-95), and the largest group was young adults (19-44 years). Abdominal pain was found in almost all research subjects. The median of leukocytes was 10.1 (3.32-65.80)×10 6/ ml and the neutrophil-lymphocyte ratio (NLR) was 3.52 (0.47-30.57)/µl. The median percentage of the neutrophil count was 70.7 (27.90-94.81). The final diagnosis of complicated appendicitis was more than uncomplicated appendicitis (51.2% vs. 48.8%). We conclude that several detailed parameters, such as the location of abdominal pain, leukocyte count, and NLR can help the physician diagnose appendicitis and guide surgeons in deciding the type of surgery.
Journal of Karnali Academy of Health Sciences
Background: Acute appendicitis is the most common general surgical disease, worldwide. The exact etiology is still in conjecture. However, the inadequate fiber in diet, smoking, mechanical obstruction in appendiceal lumen, has been attributed as factors for appendicitis. Appendicitis presents throughout months of the year, however, incidence increases in particular months. The objective of this study is to observe the appendicitis incidence variation with months of the year in high altitude region of Nepal. Methods: The cross-sectional retrospective study was conducted in the Karnali Academy of Health Sciences, Jumla situated at the altitude above 2500 m from sea level. The clinical data were retrieved from the hospital record book in the Operation Theater that included age, gender, ethnicity, month of the appendectomy executed, pre-operative clinical presentation, and operative findings. The period of study was from July 2014 to March 2020. The data were entered in Microsoft Excel...
An analysis of the consequences of acute appendicitis between urban and rural patients in Bangladesh
Journal of Applied Pharmaceutical Sciences, 2021
In acute appendicitis, timely diagnosis and rapid intervention are critical for effective management. However, geographic location and socioeconomic context can play an important role in developing countries' clinical course and outcome. The aim of this study is to observe the consequences of acute appendicitis between urban and rural patients. A prospective analytical study was conducted from April 25 to October 25, 2016, in Chittagong Medical College Hospital, Chattogram, Bangladesh. A total of 200 patients, 100 patients in each arm with a clinical diagnosis of acute appendicitis, were enrolled. 33.5% were in the age group of 21-30 years. The male:female ratio was 1.94:1. 45% of the urban patients came from the middle class, while 47% of the rural patients were from poor socioeconomic backgrounds. The mean duration of the presentation was 2.96 ± 1.88 days in urban and 5.28 ± 2.8 days in rural patients. 87% of urban and 33% of rural patients received conservative treatment before hospitalization. 74.11% of rural and 30% of urban patients delayed consenting to surgery. Perforation was found in 17.78% of urban and 33.33% of rural patients and gangrenous appendicitis in 12.22% of urban and 66.67% of rural patients. Rural patients suffered more complications like wound infection (34.4% and 68.4%, resp.), septic shock (0% and 7.9%, resp.), burst abdomen (0% and 5.3%, resp.), and death in two rural patients. Mean hospital stay was 4.37 ± 1.69 days in urban and 8.41 ± 2.44 days in rural patients. The rural population has higher morbidity and mortality when compared to the urban population of Bangladesh.
Acute appendicitis in the developing world is a morbid disease
Annals of The Royal College of Surgeons of England
ABSTRACT INTRODUCTION Acute appendicitis in the developing world has a markedly different disease profile to that in the developed world. METHODS A retrospective study was undertaken over a four-year period at a university hospital in South Africa to review the disease spectrum and the clinical outcome of acute appendicitis. RESULTS A total of 1,004 patients (54% male, median age: 18 years) with intraoperatively confirmed appendicitis were reviewed. Over half (56%) were from the urban district within the city of Pietermaritzburg and the remaining 44% were from the rural health district. The median duration of illness from onset to definitive care was 4 days. Sixty per cent of appendices were perforated and associated with intra-abdominal contamination. Forty per cent of patients required reoperation to control intra-abdominal sepsis. Ten per cent required admission to the intensive care unit. The median overall length of hospital stay was 5 days. The mortality rate was 1%. Rural pat...
Pakistan Journal of Medical and Health Sciences, 2021
Background: Appendicitis needs immediate surgical intervention based on indication in the pediatric age group. Among high-risk young children, the prevalence of pre-existing perforation ranges from 30% to 75%. Aim: To investigate the prevalence and risk factors for appendicitis in the inpatient surgical department. Place and Duration: Study was conducted at surgical department of Combined Military Hospital, Rawalakot for the period of six months from October 2020 to March 2021. Materials and Methods: A single-center cross-sectional study was conducted on 102 patients with acute appendicitis diagnosed and confirmed by Ultrasonography among the patients admitted to the surgical department during October 2020 to March 2021. Pretested questionnaire were used to collect and record the necessary information. Results: The sample size of 102 patients had 61 (60%) males and 41 (40%) were females. Appendicitis patients were divided into four age groups: 10-19 years 16 (15.7%), 20-29 years 19 ...
Acute Appendicitis in a Developing Country
World Journal of Surgery, 2012
Background This prospective audit of appendicitis at a busy regional hospital reviews the spectrum and outcome of acute appendicitis in rural and peri-urban South Africa. Method We conducted a prospective audit from September 2010 to September 2011 at Edendale Hospital in Pietermaritzburg, South Africa. Results Over the year under review, a total of 200 patients with a provisional diagnosis of acute appendicitis were operated on at Edendale Hospital. There were 128 males (64 %) in this cohort. The mean duration of illness prior to seeking medical attention was 3.7 days. Surgical access was by a midline laparotomy in 62.5 % and by a Lanz incision in 35.5 %. Two percent of patients underwent a laparoscopic appendicectomy. The operative findings were as follows: macroscopic inflammation of the appendix without perforation in 35.5 % (71/200) and perforation of the appendix in 57 % (114/200). Of the perforated appendices, 44 % (51/114) were associated with localised intra-abdominal contamination and 55 % (63/ 114) had generalised four-quadrant soiling. Thirty percent (60/200) required temporary abdominal closure (TAC) with planned repeat operation. Major complications included hospital-acquired pneumonia in 12.5 % (25/200), wound dehiscence in 7 % (14/200), and renal failure in 3 % (6/200). Postoperatively 89.5 % (179/200) were admitted directly to the general wards, while 11 % (21/ 200) required admission to the intensive care unit. The overall mortality rate was 2 % (4/200).
Acute appendicitis: Epidemiology, treatment and outcomes- analysis of 16544 consecutive cases
World journal of gastrointestinal surgery, 2016
To investigate the epidemiology, treatment and outcomes of acute appendicitis (AA) in a large population study. This is a retrospective cohort study derived from the administrative dataset of the Bergamo district healthcare system (more than 1 million inhabitants) from 1997 to 2013. Data about treatment, surgery, length of stay were collected. Moreover for each patients were registered data about relapse of appendicitis and hospital admission due to intestinal obstruction. From 1997 to 2013 in the Bergamo district we collected 16544 cases of AA, with a crude incidence rate of 89/100000 inhabitants per year; mean age was 24.51 ± 16.17, 54.7% were male and the mean Charlson's comorbidity index was 0.32 ± 0.92. Mortality was < 0.0001%. Appendectomy was performed in 94.7% of the patients and the mean length of stay was 5.08 ± 2.88 d; the cumulative hospital stay was 5.19 ± 3.36 d and 1.2% of patients had at least one further hospitalization due intestinal occlusion. Laparoscopic ...