Clinicopathological spectrum and outcome of appendicectomy at a South African tertiary hospital: continuing impact of delayed presentation

Introduction: Appendicitis is a common surgical emergency, associated with significant morbidity and mortality. Aim: To describe the clinicopathological spectrum and outcome of appendicitis in our setting. Methods: Retrospective descriptive chart review of patients undergoing surgery for appendicitis over two study periods (Group A: 2010-2012 and Group B: 2016-2018). Data collected included demographics, clinical presentation, operative findings and outcome. Results: There were 229 patients in Group A [median age 24 (IQR 18-32) years] and 145 in Group B [median age 28 (IQR 20-36) years]. Median pre-hospital delay was 3 days for Group A 3 (IQR 2-4) and 1 day for Group B 1 (IQR 1-2). Complicated appendicitis occurred in 69 (30.1%) and 37 (25.5%) patients in Group A and B respectively. Post-operative complication rate was 18.3% and 8.3 % in Groups A and B respectively. Postoperative mortality in Group A was 3.5% and 2 1% for Group B. Delay in presentation was associated with increased complicated appendicitis. Conclusion: Complicated appendicitis was seen in one third of the patients in both groups. Delay in presentation persists in our setting and it is associated with complicated appendicitis, which carries an increased morbidity and mortality. Keywords: Appendicitis; complicated appendicitis; treatment outcomes.