Appendectomy. Comparative study between a public and a private hospital

Abstract

Objective: The aim of this study is to compare data of patients submitted to appendectomy for acute appendicitis at a public hospital and at a private hospital.

Methods: A total of 200 medical records of patients submitted to appendectomy for acute appendicitis at a public hospital (n=100) and at a private hospital (n=100), was reviewed retrospectively.

Results: Mean age and gender distribution were similar for patients of both hospitals. More patients had been previously evaluated by other physicians in the group of the public hospital (n=85) than of the private hospital (n=13) (p< 0.0001). Ultrasonography was performed more frequently on patients of the public hospital (n=56) than of the private hospital (n=30) (p=0.0002). Length of hospital stay was longer at the public hospital (3.5 ± 2.8 days) than at the private hospital (2.5 ± 1.7 days) (p=0.0024). Postoperative complications were more frequent at the public hospital (n=36) than at the private hospital (n=20) (p<0.0117). Time to resume routine activities was longer for the public hospital (33.2 ± 8.3 days) than for the private hospital (16.4 ± 5.2 days) (p<0.0001). Multivariate logistic-regression analysis showed that the estimated probability of complicated appendicitis increased with the time interval between onset of symptoms and appendectomy (p<0.001). Independent risk factor associated with complicated appendicitis was the time interval between onset of symptoms and appendectomy (odds ratio 41.65, 95% CI {confidence interval} 2.90-597.49, p<0.0001) at the public hospital. There was no independent risk factor associated with complicated appendicitis at the private hospital.

Conclusion: There are important differences between public and private hospitals in the diagnosis and outcomes of patients with acute appendicitis submitted to appendectomy.