Prevalence and Risk Factors of Complicated Appendicitis at Debaratana Nakornratchasima Hospital

Abstract

Introduction: Acute appendicitis is one of the most common causes of acute abdominal pain. Without prompt treatment, it can lead to complications such as perforation, intra-abdominal abscess, or generalized peritonitis. This study aimed to determine the prevalence and factors associated with the occurrence of complications in patients with acute appendicitis.

Methods: This was a retrospective study utilizing data collection forms to extract information from medical records. A total of 458 patients diagnosed with appendicitis at Debaratana Nakhonratchasima Hospital were included. Data were analyzed using descriptive statistics and inferential statistics, including the independent t-test, chi-square test, and Mann–Whitney U test. Multivariable logistic regression was performed to identify factors associated with complicated appendicitis, with results presented as adjusted odds ratios (Adj. OR) and a significance level set at p < 0.05.

Results: Among 458 patients with acute appendicitis, 65 (14.19%) had complicated appendicitis. Multivariate logistic regression identified five significant preoperative risk factors (p < 0.05): age ≥ 50 years (adjusted odds ratio [aOR] = 2.23; 95% confidence interval [CI]: 1.11–4.45; p = 0.023), rebound tenderness (aOR = 2.67; 95% CI: 1.37–5.20; p = 0.004), neutrophil percentage (per 1% increase) (aOR = 1.09; 95% CI: 1.01–1.19; p = 0.043), symptom duration before admission (per hour) (aOR = 1.10; 95% CI: 1.07–1.13; p < 0.001), and preoperative waiting time (per hour) (aOR = 1.13; 95% CI: 1.05–1.21; p < 0.001). In addition, patients with complicated appendicitis had significantly longer operative time, greater intraoperative blood loss, a of drain insertion, and longer hospital stays (p < 0.001).

Conclusion: Older age (≥50 years), rebound tenderness, elevated neutrophil levels, prolonged symptom duration before hospital admission, and delayed surgical intervention were significantly associated with complicated appendicitis. Early diagnosis and timely surgery are essential to reduce the risk of complications.