TH5.2 Gender differences in patients undergoing emergency appendicectomy

Abstract

Abstract Aims Although appendicectomy is common, there exists minimal published literature exploring whether there are differences between adult males and females undergoing appendicectomy. This study aimed to investigate the demographics, pre-operative investigation, intra-operative findings and clinical outcomes between both genders having an emergency appendicectomy (EA). Methods A multicentre retrospective observational study was carried out across four hospitals who had an EA between August 2018 and November 2020. Patients were identified through pathology records. Data was extracted from electronic records for demographics, pre-operative (peak) blood results, pre and post-operative imaging, operative details, and the clinical outcomes. Patients were dichotomised by gender and results compared. Data was analysed using unpaired Student t test or Chi-squared test as appropriate with p < 0.05 considered statistically significant. Results 1,128 emergency appendicectomies (57.5% male) were included. Males undergoing EA were younger (median age: 34 vs 40 years, p<0.001). There was no difference in peak pre-operative white cell or neutrophil count; however, C-reactive protein was lower in male patients (median 72 vs 97, p<0.001). Pre-operative imaging was performed more often in females: ultrasound (20.7 vs 1.5%, p<0.001) and CT scan (61.8 vs 54.9%, p=0.020). Male patients underwent more open surgery (14.0 vs 6.5%, p<0.001). There was no difference in the severity of appendicitis, rate of negative appendicectomy, median total hospital stay, post-operative complication or 30-day readmission rates. Conclusions This study demonstrates that differences exist between males and females who have EA in terms of age, use of pre-operative imaging and operative approach, however, clinical outcomes are similar.