Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors
Background: Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This...
| প্রধান লেখক: | , , , , , , |
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| বিন্যাস: | প্রবন্ধ |
| ভাষা: | English |
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Surgical Society of Kenya
2021-04-01
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| মালা: | The Annals of African Surgery |
| বিষয়গুলি: | |
| অনলাইন ব্যবহার করুন: | https://www.annalsofafricansurgery.com/negative-appendectomy-tanzania |
| _version_ | 1828135488990478336 |
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| author | Masawa Klint Nyamuryekung’E Ali Athar Miten Ramesh Patel Aidan Njau Omar Sherman Ahmed JusabanI Ali Akbar Zehri |
| author_facet | Masawa Klint Nyamuryekung’E Ali Athar Miten Ramesh Patel Aidan Njau Omar Sherman Ahmed JusabanI Ali Akbar Zehri |
| author_sort | Masawa Klint Nyamuryekung’E |
| collection | DOAJ |
| description | Background: Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania. Methods: This was a cross-sectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for suspected AA with histological evaluation of specimens. The study was powered to detect the NAR at 95% confidence level and 80% power. Results: The histological NAR was 38.5% and the perforation rate was 25.3%. The Alvarado score (AS) was rarely applied (6%), despite a demonstrated ability in this study to decrease the NAR by half. Females were four times more likely to undergo negative appendectomy than males. Conclusion: The NAR is clinically significant as about two out of every five patients undergoing emergency appendectomy for suspected AA do not require the procedure. The AS is underutilized despite a demonstrated ability to decrease the NAR. We recommend that the AS be incorporated in the management of patients with suspected appendicitis. |
| first_indexed | 2024-04-11T17:47:56Z |
| format | Article |
| id | doaj.art-ababf023ca7f4483abdcf305bf98315b |
| institution | Directory Open Access Journal |
| issn | 1999-9674 2523-0816 |
| language | English |
| last_indexed | 2024-04-11T17:47:56Z |
| publishDate | 2021-04-01 |
| publisher | Surgical Society of Kenya |
| record_format | Article |
| series | The Annals of African Surgery |
| spelling | doaj.art-ababf023ca7f4483abdcf305bf98315b2022-12-22T04:11:15ZengSurgical Society of KenyaThe Annals of African Surgery1999-96742523-08162021-04-01182109114http://dx.doi.org/10.4314/aas.v18i2.9Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated FactorsMasawa Klint Nyamuryekung’E0Ali Athar1Miten Ramesh Patel2Aidan Njau3Omar Sherman4Ahmed JusabanI5Ali Akbar Zehri6Department of Surgery, The Aga Khan Hospital, Dar es Salaam, TanzaniaDepartment of Surgery, The Aga Khan Hospital, Dar es Salaam, TanzaniaDepartment of Surgery, The Aga Khan Hospital, Dar es Salaam, TanzaniaDepartment of Surgery, The Aga Khan Hospital, Dar es Salaam, TanzaniaDepartment of Surgery, The Aga Khan Hospital, Dar es Salaam, TanzaniaDepartment of Surgery, The Aga Khan Hospital, Dar es Salaam, TanzaniaDepartment of Surgery, The Aga Khan Hospital, Dar es Salaam, TanzaniaBackground: Acute appendicitis (AA) has a lifetime risk of 8.3% with a consequent 23% lifetime risk of emergency appendectomy. In atypical presentation, making a clinical diagnosis is difficult, leading to a high perforation rate (PR) or misdiagnoses and high negative appendectomy rates (NAR). This study aimed to establish NAR and explore the associated factors and possible attainable solutions to reduce it in urban referral hospitals in Tanzania. Methods: This was a cross-sectional study with 91 consecutive patients, aged 10 years and older undergoing appendectomy for suspected AA with histological evaluation of specimens. The study was powered to detect the NAR at 95% confidence level and 80% power. Results: The histological NAR was 38.5% and the perforation rate was 25.3%. The Alvarado score (AS) was rarely applied (6%), despite a demonstrated ability in this study to decrease the NAR by half. Females were four times more likely to undergo negative appendectomy than males. Conclusion: The NAR is clinically significant as about two out of every five patients undergoing emergency appendectomy for suspected AA do not require the procedure. The AS is underutilized despite a demonstrated ability to decrease the NAR. We recommend that the AS be incorporated in the management of patients with suspected appendicitis.https://www.annalsofafricansurgery.com/negative-appendectomy-tanzanianegative appendectomy ratesub-saharan africaalvarado scoreappendectomysuspected acute appendicitis |
| spellingShingle | Masawa Klint Nyamuryekung’E Ali Athar Miten Ramesh Patel Aidan Njau Omar Sherman Ahmed JusabanI Ali Akbar Zehri Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors The Annals of African Surgery negative appendectomy rate sub-saharan africa alvarado score appendectomy suspected acute appendicitis |
| title | Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors |
| title_full | Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors |
| title_fullStr | Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors |
| title_full_unstemmed | Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors |
| title_short | Negative Appendectomy Rate in Urban Referral Hospitals in Tanzania: A Cross-sectional Analysis of Associated Factors |
| title_sort | negative appendectomy rate in urban referral hospitals in tanzania a cross sectional analysis of associated factors |
| topic | negative appendectomy rate sub-saharan africa alvarado score appendectomy suspected acute appendicitis |
| url | https://www.annalsofafricansurgery.com/negative-appendectomy-tanzania |
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