Burden of negative appendectomy at a District General Hospital: a two-year cross-sectional review

Abstract

INTRODUCTION: The average negative appendectomy rate (NAR) in the UK is relatively high when compared to other high-income countries. Associated factors and complications following NAR defer in literature. The main objective of this paper is to report the short and long-term re-admission following a NAR, secondary objectives were to assess the characteristics of NAR patients and their Alvarado’s score. METHODS: A two-year retrospective observational study was performed on patients undergoing emergency appendectomy. Patient demography, data and follow-up records were extracted from electronic patient records. RESULTS: Four hundred and seventy-eight (478) patients underwent emergency appendectomy over the study period. 7 patients were excluded due to incomplete patient records. 471 patients met the study criteria; median age at presentation was 27 (IQR 19 - 39) years, mean age of 32 (SD 16.3) years. 245 (52%) were male. Among this cohort, 355 patients (75.4%) underwent appendectomy for histologically proven appendicitis, while 12 patients (2.5%) and 19 patients (4%) were diagnosed via histology to have appendicular faecolith without inflammatory change and lymphoid hyperplasia respectively, an additional 12 patients (2.5%) had unexpected histological findings. Conversely, 73 patients (15.5%) underwent negative appendectomy. Re-presentation within thirty-days was 5.5% vs. 11% (p=0.2001) while re-presentation beyond thirty-days was 21.9% vs. 4.2% (p