Proportion and Factors Associated with Ruptured Appendicitis Among Patients Undergoing Appendectomy at Lampang Hospital: A Retrospective Cohort Study
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Abstract
Background: Ruptured appendicitis is associated with increased postoperative morbidity and prolonged hospitalization. Contemporary data from regional referral hospitals may help quantify the local burden, describe postoperative outcomes, and identify priorities for prospective data collection and quality improvement.
Objective: To determine the proportion of intraoperatively confirmed ruptured appendicitis, describe its clinical characteristics and postoperative outcomes, and explore associations between routinely available preoperative variables and appendiceal rupture among patients undergoing appendectomy at Lampang Hospital.
Materials and Methods: This retrospective cohort study included patients aged ≥15 years with operatively confirmed appendicitis treated between October 1, 2023, and September 30, 2024. Demographic, clinical, laboratory, and treatment data were extracted from medical records and compared between the ruptured and non-ruptured groups. Exploratory multivariable logistic regression was used to evaluate adjusted associations with rupture. Missing data were handled using multiple imputation by chained equations.
Results: Among 443 eligible patients, 153 had intraoperatively confirmed ruptured appendicitis (34.5%). Postoperative fever (69.9% vs 38.6%; p<0.001) and surgical site infection (13.7% vs 1.4%; p<0.001) were more frequent in the ruptured group. In exploratory multivariable analysis, male sex (adjusted odds ratio [aOR] 1.58; 95% confidence interval [CI] 1.04–2.39), age older than 60 years (aOR 3.11; 95% CI 2.01–4.81), and each 1 °C increase in admission temperature (aOR 1.36; 95% CI 1.09–1.71) were associated with higher odds of rupture.
Conclusion: Ruptured appendicitis accounted for 34.5% of appendectomy cases and was associated with a greater postoperative complication burden. The observed associations with sex, age, and admission temperature are exploratory and should not be used as standalone prediction or triage criteria because key examination, imaging, referral, and timing variables were unavailable. Prospective standardized data collection is needed to identify modifiable targets for local quality improvement.
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บทความที่ส่งมาลงพิมพ์ต้องไม่เคยพิมพ์หรือกำลังได้รับการพิจารณาตีพิมพ์ในวารสารอื่น เนื้อหาในบทความต้องเป็นผลงานของผู้นิพนธ์เอง ไม่ได้ลอกเลียนหรือตัดทอนจากบทความอื่น โดยไม่ได้รับอนุญาตหรือไม่ได้อ้างอิงอย่างเหมาะสม การแก้ไขหรือให้ข้อมูลเพิ่มเติมแก่กองบรรณาธิการ จะต้องเสร็จสิ้นเป็นที่เรียบร้อยก่อนจะได้รับพิจารณาตีพิมพ์ และบทความที่ตีพิมพ์แล้วเป็นสมบัติ ของลำปางเวชสาร
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