Association between Duration of Onset Longer than 24 Hours and Perforated Appendicitis in Si Sa Ket Hospital: A Hospital-based Case-control Study
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Abstract
BACKGROUND: The incidence of ruptured appendicitis is very common among the general public, particularly in children and the elderly, which affects the duration of treatment and patient mortality.
OBJECTIVES: To study the relationship between the duration of disease progression greater than 24 hours and the occurrence of ruptured appendicitis.
METHODS: A Hospital-based case-control study was conducted to obtain data from medical records. The study group included 167 individuals with ruptured appendicitis, whereas the control group included 167 patients with pathologically confirmed non-ruptured appendicitis. All patients were admitted to Si Sa Ket’s Hospital. After collecting data between January 1 and December 31, 2019, multivariable logistic regression was applied to explore the association.
RESULTS: After correcting for the impact of gender, age, and the Alvarado score, the results of multivariable regression analysis revealed that a delay of more than 24 hours between the onset of abdominal discomfort and the visit to the operating room increased the incidence of ruptured appendicitis, which was statistically significant. It was discovered that patients who experienced stomach pain for longer than 24 hours before having surgery had a 2.76 times higher risk of developing an appendicitis rupture compared with the group whose time to surgery was no longer than 24 hours (ORadj=2.76, 95%CI=1.68–4.52). Moreover, this study found that, the likelihood of appendicitis rupture rose to 4.15 times if the period from the beginning of abdominal discomfort to the patient's arrival at the operating room was more than 36 hours (ORadj=4.15, 95%CI=2.57–6.66).
CONCLUSIONS: The time between the onset of symptom and surgical intervention appeared to be strongly correlated with cases of rupture appendicitis. As a result, public awareness concerning the usage of both emergency medical services and physicians is critical to the management of appendicitis in order to lower the incidence of ruptured appendicitis.
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