A STUDY OF NON-PATIENT FACTORS CONTRIBUTING TO RUPTURED APPENDICITIS IN SWAT.
DOI:
https://doi.org/10.52206/jsmc.2012.2.1.117-126Abstract
Background: Ruptured appendicitis is still prevalent. Adult rates of ruptured appendicitis vary from 13.2
to 41.9 percent in bigger hospitals, despite controlling for individual factors like age, sex, co morbidity and
socioeconomic status. This suggests an effect of hospital organization. Surgeons report that
appendicectomies may be delayed because of lack of access to operating theater.
Methods: Combining interviews with hospital personnel and information from the medical record, for
year 2011, a cross sectional study was conducted on 4305 patients. Four hospitals were included in the
study. The diagnostic information was recorded to ensure inter hospital validity. Results: Hospital with
high activity and volume of patients, but without an operation theatre designated for urgent surgery, was
associated with a significant higher rate of peritonitis (P=< 0.050). Time to surgery after departure from
Accident and Emergency department, was very long in hospital having no operating theater for urgent
surgery particularly elderly patients.
Conclusion: Hospital characteristics in unfavorable combinations influence the course of time-dependent
disease such as appendicitis. Difficulties in gaining access to operating theater, even for urgent operations,
have emerged. Delays in treatment must be addressed when planning healthcare reforms.
Keywords: Perforated appendicitis, peritonitis, urgent surgery
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