Factors Associated with Ruptured Appendicitis at the Surgery Department, Kaeng Khro Hospital, Chaiyaphum
Article Sidebar
Main Article Content
Abstract
Background: Acute appendicitis is one of the most common causes of acute abdominal pain that leads patients to seek services at the emergency department and requires emergency surgery.
Objective: To study the surgical outcome and risk factors of ruptured appendicitis at The Surgery Department, Kaeng Khro Hospital, Chaiyaphum Province.
Methods: Patients diagnosed with appendicitis and who underwent surgery at Kaeng Khro Hospital between July 1st., 2021, and April 30th., 2024, were included in this study. We conducted a retrospective review of the patient's characteristics, clinical data, surgical procedures, and post-operative outcomes. We analyzed the risk factors and clinical outcomes associated with ruptured appendicitis.
Results: A total of 237 patients were assessed, of which 185 (78.1%) had acute appendicitis and 52 (21.9%) presented with ruptured appendicitis. Mean age of ruptured appendicitis group was significantly different from acute appendicitis group (43.8±19.5 years vs 31.8±20.5 years; p<0.001). Duration from onset of abdominal pain to arrival at the hospital was significantly different from acute appendicitis group (35.7±28.8 hours vs 20.3±18.2 hours; p<0.001). Clinical peritonitis was significantly different from acute appendicitis group (76.9% vs 7.0%; p<0.001). Surgical outcomes demonstrated significant differences in operative time (45.7±16.2 min vs. 29.2±11.6 min, p<0.001), estimated blood loss (33.8±49.7 ml vs. 8.8±16.2 ml, p<0.001), and length of hospital stay (LOS) (3.8±1.7 days vs. 2±1.1 days, p<0.001). After multi-logistic regression analysis, peritonitis observed during the physical examination is associated with ruptured appendicitis (OR=89.7, [95% CI 15.7-513.5]). Additionally, operative time and length of stay (LOS) were also associated with ruptured appendicitis (OR=1.1, [95% CI 1.0-1.1] and OR=2.0 [95% CI 0.1-21.7]).
Conclusion: Factors associated with the occurrence of ruptured appendicitis include physical examination finding generalize peritonitis. The occurrence of ruptured appendicitis significantly increases the duration of operation time and the length of hospital stay.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg 2020;15(1):27. doi: 10.1186/s13017-020-00306-3.
Ceresoli M, Zucchi A, Allievi N, Harbi A, Pisano M, Montori G, et al. Acute appendicitis: Epidemiology, treatment and outcomes- analysis of 16544 consecutive cases. World J Gastrointest Surg 2016;8(10):693-9. doi: 10.4240/wjgs.v8.i10.693.
Livingston EH, Woodward WA, Sarosi GA, Haley RW. Disconnect between incidence of nonperforated and perforated appendicitis: implications for pathophysiology and management. Ann Surg 2007;245(6):886-92. doi: 10.1097/01.sla.0000256391.05233.aa.
Chatbanchai W, Hedley AJ, Ebrahim SB, Areemit S, Hoskyns EW, de Dombal FT. Acute abdominal pain and appendicitis in north east Thailand. Paediatr Perinat Epidemiol 1989;3(4):448-59. doi: 10.1111/j.1365-3016.1989.tb00532.x.
Echevarria S, Rauf F, Hussain N, Zaka H, Farwa UE, Ahsan N, et al. Typical and Atypical Presentations of Appendicitis and Their Implications for Diagnosis and Treatment: A Literature Review. Cureus 2023;15(4):e37024. doi: 10.7759/cureus.37024.
World health Rankings: Live Longer Live Better. Thailand appendicitis [Internet]. 2020. [Cited 2023 Jan 30]. Available from:URL:https://www.worldlifeexpectancy.com/thailand-appendicitis.
Wayne W. Biostatistics A foundation for analysis in the health sciences. 6th. ed. New York : Wiley & Sons ; 1995 : 244-6.
อดุลกฤษณ์ นาต๊ะ. อุบัติการณ์และปัจจัยเสี่ยงที่มีผลต่อการเกิดไส้ติ่งแตกในผู้ป่วยที่ได้รับการผ่าตัดไส้ติ่ง โรงพยาบาลแม่ระมาด จังหวัดตาก. วารสารวิชาการสาธารณสุขจังหวัดตาก 2566;3(3):1-15.
นภาพงษ์ ประดับสุข. ปัจจัยที่สัมพันธ์กับการเกิดภาวะไส้ติ่งแตกในโรงพยาบาลชุมชน. วารสารการแพทย์โรงพยาบาลศรีสะเกษ สุรินทร์ บุรีรัมย์ 2566;38(3):913-23.
ดำรงรักษ์ ชูไพฑูรย์. ปัจจัยที่สัมพันธ์กับการแตกของไส้ติ่งอักเสบในผู้ป่วยโรงพยาบาลปราณบุรี. วารสารหัวหินสุขใจไกลกังวล 2562;4(3):e0073.
อุไร ทรงแก้ว. ปัจจัยที่เกี่ยวข้องกับการเกิดภาวะไส้ติ่งแตกในผู้ป่วยไส้ติ่งอักเสบโรงพยาบาลทุ่งสง จังหวัดนครศรีธรรมราช. มหาราชนครศรีธรรมราชเวชสาร 2561;2(1):31-8.
ไพจิตร อธิไภริน. ปัจจัยทำนายทางคลินิกต่อการเกิดภาวะไส้ติ่งแตกในผู้ป่วยไส้ติ่งอักเสบเฉียบพลัน. มหาราชนครศรีธรรมราชเวชสาร 2565;6(1):92-101.
Tantarattanapong S, Arwae N. Risk factors associated with perforated acute appendicitis in geriatric emergency patients. Open Access Emerg Med 2018;10:129-34. doi: 10.2147/OAEM.S173930.
