Prevalence, management outcome and factors affecting management outcome of acute appendicitis at mizan aman general hospital, southwest Ethiopia, 2011-2014

Abstract

Background: Appendicitis is a condition characterized by inflammation of the vermiform appendix. It is classified as a surgical emergency and many cases require removal of the inflamed appendix either by laparotomy or laparoscopy. Untreated, mortality is high, mainly because of rupture leading to peritonitis and shock. However, there is scarcity of information on the prevalence of acute appendicitis in the current study area Objectives: To determine the prevalence and management outcome of acute appendicitis in Mizan Aman General Hospital, in Southern Nations Nationalities of People’s Regional State, Southwest Ethiopia. Methods: Retrospective review of hospital records of all 182 cases with acute appendicitis surgically managed at MizanAman General Hospital was retrieved from April 01, 2011-March 31, 2014. Secondary data was collected using structured check list, checked for its Completeness, entered, edited, cleaned and analyzed by SPSS version 20.0. Descriptive analysis was used to describe socio-demographic variables and logistic regression was carried out to see the effect of independent variables on outcome of acute appendicitis. Significant factors were reported at p< 0.05. The result was presented using text, tables and graphs. Results: Hundred and eighty two patients were operated for acute appendicitis. Of whom 120 (65.9%) were male patients and 62 (33.1%) were female patients (Male to female ratio of 1.94:1). The mean and median age was 23.18±11.90 SD and 21 years respectively, where majority of the patients were in the second decades of life. The annual incidence of the disease was uniform, (about 56-67cases per year) during the study period. Abdominal pain was invariably the main presenting compliant in 182 (100%) and right lower quadrant abdominal tenderness was the dominant physical finding in 106(58.2%) of these patients. The rate of perforated appendix was 40(22%). Appendectomy was done for 168 (92.3%) patients of whom the negative appendectomy rate comprised 12.5%. The predominant postoperative complication was postoperative wound infection in 43/58 (66%). The average length of hospital stays was 6.5 days. Death rate of patients due to appendicitis was 0.55%. Conclusion and Recommendations: Acute appendicitis mainly affects the young population group in the second decades of life and males are more vulnerable and its prevalence was 182/376 (48.3%). The main presenting compliant, physical finding, intraoperative finding, and postoperative complication were abdominal pain, right lower quadrant abdominal tenderness, inflamed appendix, and postoperative wound infection respectively. Therefore, working up on patients with abdominal pain for acute appendicitis and validating this subjective complaint of the patient with proper history taking and physical examination, with relevant laboratory investigations, and thorough perioperative, postoperative care and revising the infection prevention practice in surgical ward will improve the management outcome of the p