Frequency, Causes and Outcomes of Delayed Appendectomy in Patients with Acute Appendicitis

Aims: To determine the frequency and causes of delayed appendectomy also examine the outcomes associated with delayed appendectomy in patients presented with acute appendicitis. Study Design: Retrospective/Observational Place and Duration of Study: Ghulam Muhammad Mahar Medical College Hospital, Sukkur from 1st January 2017 to 31st December 2019. Methodology: Two hundred and ninety patients of both gender presented with acute appendicitis with ages 18 to 45 years were included in the study. Patients detailed demographic including age, sex, body mass index and complete blood count were recorded after taking written consent. All patients had gone through appendectomy under general anaesthesia. Frequency of delay in appendectomy and its causes were recorded. Patients received appendectomies after 12 hours of symptoms onset were considered as delayed. Outcomes such as hospital stay, wound infection, and perforation were examined. Results: There were 182 (62.75%) male while females were 108 (37.24%) with mean age 32.48 +/- 4.62 years. Mean BMI was 25.24 +/- 2.04 kg/m(2). Delayed appendectomy was found in 72 (24.83%) patients. Misdiagnosed was the commonest cause of delay appendectomy found in 34 (47.22%) patients followed by afraid of operation in 20 (27.78%) and self medication in 13 (18.06%) patients. Patients with delayed appendectomies had higher perforation rate as compared to patients with no delay [24 (33.33%) vs 22 (10.09%)] p-value <0.05. Hospital stay was lower in patients received appendectomy within 12 hours as compared to delayed (1.89 +/- 1.03 days vs 2.76 +/- 1.44 days) p-value <0.05.Wound infection in delayed appendectomies found in 5 (6.94%) while in not delayed patients it was found in 4 (1.83%) patients the difference was not statistically significant. Conclusion: Frequency of delayed appendectomy was high and misdiagnosed was the commonest cause of delayed appendectomy. Delayed appendectomy was significantly associated with perforation and longer hospital stay.