ASSESSMENT OF UNFAVORABLE TREATMENT OUTCOME OF ACUTE APPENDICITIS AND ITS ASSOCIATED FACTORS IN PATIENTS MANAGED SURGICALLY IN GELEMSO GENERAL HOSPITAL, OROMIA REGIONAL STATE, EASTERN ETHIOPIA.

Abstract

Back ground: Acute appendicitis is the commonest cause of surgical abdomen. Obstruction of the lumen due to fecaliths or hypertrophy of lymphoid tissue is proposed as the main cause in acute appendicitis. Few studies had shown treatment outcome and factors associated with unfavorable outcome of acute appendicitis in Ethiopia as well as in Gelemso general hospital. Objective: To assess unfavorable treatment outcome of acute appendicitis and its associated factors in patients treated surgically in Gelemso general hospital from June 1/2015-May 30/2018. Method: A retrospective cross-sectional study was conducted on sample of 201 operated cases from June 1/2015 to May 30/2018 in Gelemso general hospital. Secondary data was collected using structured checklist by trained data collectors. Data was cleaned, edited and entered to epidata 3.02 and analyzed by SPSS version 22 using both descriptive and inferential statistics. Binary and multivariate logistic regression was employed in order to determine the relationship between dependent and independent variables at p-value <0.05. Result; Among a sample of 201 patients operated for acute appendicitis, result showed inflamed appendix 153(76.1%), perforated appendix 26(12.9%) ,gangrenous appendix with pus or abscess 22(10.9%) .167(83.1%) of patients had no complication where as 34 (16.9%) had postoperative wound infection. Age>55years (AOR 95%CI0.003 (0.00-0.269) for age< 14years and 0.052(0.003- 0.891) for age group between 14-54 years,), duration of illness prior to intervention (AOR, 95%CI is 0.01(0.001-0.116)for patients intervened with in two days), perforated appendix (AOR=26 and 95%CI (1.6-422.6)) were associated with unfavorable management outcome. Death of patients due to complication of appendicitis was not recorded during the study period. Conclusion and recommendation: Post operative wound infection is the only complication. Old age, delay presentation to hospital and perforated appendix were associated with unfavorable management outcome. Efforts and mission of health professional, Gelemso hospital administrative and health professionals, Zonal Health Office and community health workers must be directed towards community education on health seeking behavior to prevent unnecessary pre hospital delay with severe abdominal pain, appropriate usage of medications and following aseptic surgical technique at operation room with appropriate post operative wound care improve outcome