Abstract

GARCIA TAY, Jorge Alfredo Gerardo  and  HERNANDEZ ORTEGA, José Luis. Delay in the request for health care and other factors associated with appendix perforation in patients with acute appendicitis. Rev. Fac. Med. (Méx.) [online]. 2013, vol.56, n.3, pp.21-25. ISSN 2448-4865.

Background: Appendiceal rupture is the most severe complication of acute appendicitis, since it has high morbidity and mortality rates. It has been suggested that the risk of appendiceal rupture is related to the time the patient takes to ask for medical help, previous medication, and te patient's type of insurance. Objective: To establish the factors related to the appendiceal rupture in patients with acute appendicitis who attended the Centro Hospitalario Nuevo Sanatorio Durango from January 2008 to October 2012. Material and metodology: Patients who had undergone appendectomy for acute appendicitis were studied and 2 groups were formed: Appendiceal rupture group and Nonappendiceal rupture group. The time of evolution (in hours) until admittance to the hospital, as well as age, sex, type o insurance (personal, company), comorbidity, and if the patient had taken any medication before looking for medical help, were the patient's features assessed. Results: From 189 patients who underwent appendectomy for acute appendicitis, 69 (36%) presented appendiceal rupture. These patients had two more hours of evolution (26 vs 24 horas, p<0.001) on average before receiving medical help; which meant 2% higher risk per hour (IC 95% de 0.2% a 4%, p = 0.03). Other factors associated were previous medication (RM = 23, IC 95% 9 a 57), having company insurance (RM = 3.3, IC 95% 1.6 a 10). Conclusions: the factors associated with appendiceal perforation were delay in medical attention, previous medication, and the type of insurance owned by the patient.

Keywords : acute appendicitis; appendiceal rupture; prior medication; type of health insurance.

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