Is language disability a risk factor for complicated appendicitis? A retrospective cohort study

Abstract

Aim: Acute appendicitis is the most common emergent surgical disease and complicated appendicitis is an indicator of disrupted access to healthcare. Language disability has become more important in the healthcare sector with increasing migration in the last decade. We aimed to evaluate language disability as a risk factor for complicated appendicitis. Methods: From January 2014 to December 2018, patients who were operated for acute appendicitis were evaluated retrospectively. Patients’ age, gender, language disability (LD) (no (C) or yes (F)), whether surgical drainage was required, pathological findings (appendix diameter, severity as uncomplicated (UCA) or complicated (CA), and presence of local peritonitis), levels of C-Reactive Protein (CRP), White Blood Cells (Wbc), Neutrophil% (Neu%), and ultrasonography (USG) and computed tomography (CT) results were noted and compared. Results: Six hundered twenty-eight patients were included in the study, among which 15.1% (n=95) were considered F, and 12% (n=74) were CA. Age and gender did not significantly differ in terms of LD and severity (P=0.15, P=0.24 and P=0.2, P=0.21, respectively). Drainage requirement, local peritonitis, levels of CRP, Wbc, and Neu% were significantly higher in the CA group (P<0.001, P<0.001, P<0.001, P=0.009, and P<0.001, respectively). Drainage, appendix diameter, levels of CRP, and Neu% were significantly higher in the F group (P=0.01, P=0.04, P=0.007, and P=0.046, respectively). CA rate was insignificantly higher in the F group (17% vs 11%) (P=0.72). The false-negative ratio of USG and CT was higher in F patients with CA (56.2% vs. 37.5%). Conclusion: This study showed that language disability could be a risk factor for complicated appendicitis with higher drainage ratio, appendix diameter, levels of CRP, and Neu%.

Keywords

• Appendicitis
• Severity
• Language Disability

Dil engeli, komplike apandisit için bir risk faktörü müdür? Geriye dönük kohort çalışma

Öz

Amaç: Akut apandisit en sık acil cerrahi hastalık ve komplike apandisit sağlık kuruluşlarına erişebilme göstergesidir. Son on yılda göçlerin artması ile dil engeli sağlık için önemli hale gelmiştir. Dil engelinin komplike apandisit için risk faktörü olarak değerlendirmeyi amaçladık. Yöntemler: Ocak 2014’den Aralık 2018 tarihleri arasında akut apandisit nedeni ile opere edilen hastalar geriye dönük değerlendirildi. Hastaların yaş, cinsiyet, dil engeli (DE) (var (Y) yok (V)), drenaj uygulanması, patolojisi (apandiks çapı, şiddeti komplike olan (KA), komplike olmayan (KOA), ve lokal peritonit varlığı), C-Reaktif Proteini (CRP), beyaz küre (BK), nötrofil yüzdesi (Nöt%), ultrasonografi (US) ve bilgisayarlı tomografi (BT) sonuçları istatistiksel olarak değerlendirildi. Bulgular: Altı yüz yirmi sekiz hasta çalışmaya dahil edildi. %15,1’i (n=95) Y, ve %12’si (n=74) KA idi. DE ve şiddet açısından yaş ve cinsiyet farkı istatistiksel olarak anlamlı saptanmadı (sırasıyla P=0,15, P=0,24 ve P=0,2, P=0,21). Drenaj, lokal peritonit, CRP, BK ve Nöt% KA grubunda anlamlı olarak yüksek saptandı (sırasıyla P<0,001, P<0,001, P<0,001, P=0,009, ve P<0,001). Drenaj, apandiks çapı, CRP ve Nöt% seviyesi Y gurunda anlamlı olarak yüksek saptandı (sırasıyla P=0,01, P=0,04, P=0,007 ve P=0,046). KA oranı Y grubunda daha fazla olmasına rağmen (%17 karşı %11) istatistiksel olarak anlamlı (P=0,72). US ve BT’nin yalancı negatiflik oranı KA’lı Y grubunda daha yüksek saptandı (%56,2 karşı %37,5). Sonuç: Bu çalışma dil engelinin; yüksek drenaj oranı, apandiks çapı, CRP ve Nöt% seviyeleri ile komplike apandisit için bir risk faktörü olabileceğini göstermiştir.

Anahtar Kelimeler

• Apandisit
• Şiddet
• Dil engeli

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