Factors associated with early inhospital adverse outcome following surgery for acute appendicitis in Uganda: A multicenter cohort

Abstract

Abstract Introduction: The surgery for acute appendicitis has been associated with significant morbidity. This study aimed to determine the factors associated with early inhospital adverse outcome following surgery for acute appendicitis in Uganda. Methods This was a multicentre prospective cohort in which early inhospital outcome following surgery for acute appendicitis was assessed at 4 regional referral hospitals in Uganda. The occurrence of complications during the admission period was documented as well as the length of hospital stay. The factors associated with the adverse outcomes were determined using Poisson regression in SPSS version 26. Results Of the 102 patients that underwent surgery for acute appendicitis, majority were males 79(77.5%) with a mean age of 23.8(SD = 12.5) years. Perforated appendix was seen in 26 (25.5%) patients. Post-operative complications occurred in 21(20.6%) with the commonest being surgical site infection seen in 19(18.6%) patients. The median length of hospital stay was 3(IQR = 3–4) days with 43(42.2%) staying in hospital for more than 3 days. Presence of anemia (Hb < 8) (aRR = 1.376, CI = 1.159–1.634, P = < 0.001) and having a perforated appendix (aRR = 1.263, CI = 1.026–1.555, P = 0.027) were independently associated with occurrence of complications while being HIV positive (aRR = 1.379, CI = 1.105–1.721, P = 0.005) and having a perforated appendix (aRR = 1.258, CI = 1.019–1.554, P = 0.033) were independently associated with prolonged hospital stay. Conclusion Sensitization of the community about early presentation is still required in order to reduce the number of patients that present late, which will in turn reduce the risk of complications and length of hospital stay.