Evaluation of re-admission after open appendicectomy

Objective To determine the causes of re-admissions in patients undergoing open appendicectomy. Patients and Methods This prospective cross-sectional study was conducted at Department of Surgery LUMHS, for three years from January 2007 to December 2009. Patients presented for readmission within one year after undergoing open appendicectomy were included in the study. Indications of readmission were determined mostly by clinical basis. Results Out of total 461 patients who underwent appendectomy, 28(6.07 %%) were readmitted (female=17, male=11). Twenty (71%) were readmitted within first two weeks after initial discharge. Indications at subsequent readmission were nonspecific abdominal pain in 39.3%, wound infection in 28.6%, small bowel obstruction in 17.9%, pelvic abscess in 7.2%, fecal fistula in 3.5%, and stump appendicitis in 3.5%. In the readmitted patients 68.7% had normal looking appendix preoperatively and they had shorter initial hospital stay. Conclusion Female sex, perforated appendix and normal morphological appearance of appendix at operation were factors, which may predict readmission. Proper evaluation of symptoms especially in female patients may reduce readmission rate. Hence associated adverse effects of readmissions like additional treatment and cost can be reduced.