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Meta-Analysis
. 2025 Aug 9;25(1):354.
doi: 10.1186/s12893-025-03108-z.

Unfavorable management outcome and its predictors among appendicitis patients in ethiopia: a systematic review and meta- analysis

Mulualem Gete Feleke  1 , Tadele Lankrew Ayalew  2 , Kidist Ashager  2 , Hailu Asmare Beyene  2 , Moges Wubneh Abate  3 , Nigusie Selomon Tibebu  4
Affiliations
Meta-Analysis

Unfavorable management outcome and its predictors among appendicitis patients in ethiopia: a systematic review and meta- analysis

Mulualem Gete Feleke et al. BMC Surg. .

Abstract

Background: Appendicitis is life-threatening abdominal surgical emergency worldwide, requires timely medical intervention to prevent adverse outcomes such as wound infection, pneumonia, intra-peritoneal fluid collection, and death. These complications remain a significant challenge in Ethiopia. This study aimed to assess the pooled magnitude of unfavorable management outcome and identify associated factors among appendicitis patients in Ethiopia.

Methods: We conducted a systematic search of databases for studies reporting appendicitis outcomes in Ethiopia. Eligible studies were screened based on predefined criteria. Statistical analyses were performed using STATA version 14. Heterogeneity was assessed with I² and Cochran's Q tests; due to substantial heterogeneity, a random-effects model was applied. Publication bias was evaluated using funnel plots, Egger's test, and the trim-and-fill method. Subgroup analyses explored sources of heterogeneity based on study region and hospital type.

Results: Eighteen studies articles were included. The pooled prevalence of unfavorable management outcome among appendicitis patient was 12.71% (95%CI: 9.32-16.09). Sub-group analysis showed that Oromia region had the highest prevalence of poor management outcome. Duration of illness [AOR = 4.41 (95%CI: 1.42-13.70)], right lower quadrant abdominal mass [AOR = 4.1 (95%CI: 2.29-7.34)], presence of intraoperative abscess [AOR = 6.9 (95% CI: 3.61-13.22)], lengths of postoperative hospital stays [OR = 5.28 (95%CI: 2.31-12.04)], elevated white blood cell count [AOR = 4.09 (95%CI: 2.22-7.54)] were a significant association with unfavorable management outcome of appendicitis.

Conclusion: Unfavorable management outcomes in appendicitis patients in Ethiopia are significantly associated with several clinical factors. Enhancing early diagnosis, prompt surgical intervention, and standardized postoperative care are essential to reduce these adverse outcomes.

Keywords: Appendicitis; Ethiopia; Factors; Management outcome; Unfavorable.

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Conflict of interest statement

Declarations. Competing interests: The authors declare no competing interests. Consent to publish: Not applicable. Ethics approval and consent to participate: Not applicable.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram illustrating the study selection process for the systematic review and meta-analysis on unfavorable management outcomes of appendicitis in Ethiopia, 2025
Fig. 2
Fig. 2
Forest plot showing the pooled prevalence of unfavorable management outcomes among appendicitis patients in Ethiopia, 2025
Fig. 3
Fig. 3
Forest plot of subgroup analysis showing prevalence of unfavorable management outcomes of appendicitis by regions, Ethiopia, 2025
Fig. 4
Fig. 4
Forest plot of Subgroup analysis of showing the prevalence of unfavorable management outcomes of appendicitis by hospital types, Ethiopia, 2025
Fig. 5
Fig. 5
Forest plot of Subgroup analysis of showing the prevalence of unfavorable management outcomes of appendicitis by time period, Ethiopia, 2025
Fig. 6
Fig. 6
Pooled odds ratios (log scale) for predictors of unfavorable management outcomes of appendicitis in Ethiopia 2025: (A) Duration of illness, (B) Right lower abdominal quadrant mass, (C) intraoperative abscess, (D) Length of hospital stay, (E) Elevated WBC
Fig. 7
Fig. 7
Egger regression test assessing publication bias for unfavorable management outcomes in appendicitis patients in Ethiopia, 2025
Fig. 8
Fig. 8
Funnel plot assessing publication bias for unfavorable management outcomes in appendicitis patients in Ethiopia, 2025
Fig. 9
Fig. 9
Sensitivity analysis assessing the influence of each individual study on the pooled prevalence in the systematic review and meta-analysis of unfavorable management outcomes among appendicitis patients in Ethiopia, 2025
See this image and copyright information in PMC

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