Predictors of complicated appendicitis among patients presented to public referral hospitals in Harari region, Eastern Ethiopia: a case-control study

Abstract

Complicated appendicitis makes up a significant proportion of acute appendicitis. There are well established associated factors for the development of complications, but the magnitude varies between developed and developing countries. This study was aimed to look for possible incriminated factors for higher rate of complicated appendicitis among patients treated in public hospitals found in the Harari region, Eastern Ethiopia. Multi-center case-control study with 1:2 was conducted on adult complicated appendicitis patients. The sample size of 414 was determined using an Open Epi and a simple random sampling technique was used to select the samples. Kobo collect was used for data collection by trained medical doctors. Data analysis was made using a statistical package for social studies version 23. The findings were presented in tables and elaborated in texts. Binary logistic regression analysis was conducted to determine association between predictors and outcome variable with adjusted odds ratio at 95% confidence interval, p value less than 0.05. A total of 402 patients included in the study with 268(66.7%) simple appendicitis and 134(33.3%) complicated appendicitis. More patients with complicated appendicitis had a history of another health facility visit compared to the simple appendicitis groups. Duration of chief complaint, history of constipation, having history of visit to health facilities without surgical intervention for their current problem and fever has shown moderate to strong associations on binary logistic regression analysis. Delayed presentation, patients who had a history of a visit to primary health care facilities and private clinics where surgical intervention not available were also found to have an increased risk of developing complicated appendicitis.