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CC BY 4.0 · Journal of Coloproctology 2024; 44(01): e27-e32
DOI: 10.1055/s-0044-1779602
Original Article

Retrospective Study of Patients Submitted to Appendectomy in a Tertiary Hospital: Is There a Difference between the Public and Supplementary Health System?

Isaac José Felippe Corrêa Neto 
1   Department of Semiology, Medical Propaedeutics and General Surgery, Faculdade Santa Marcelina, São Paulo, SP, Brazil
2   Department of General Surgery, Service of Colon and Rectal Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil
,
Amanda Gambi Robles
2   Department of General Surgery, Service of Colon and Rectal Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil
,
Victor Keniti Gomes Nishiyama
2   Department of General Surgery, Service of Colon and Rectal Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil
,
Sany Tomomi de Almeida Rocha Arita
5   Department of Surgery of the Digestive Systemand Coloproctology, Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil
,
Gabriel Fiorot Cruz Sperandio
6   Services of General Surgery and Coloproctology, Department of General Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil
,
Lia Yumi Omori Nishikawa
6   Services of General Surgery and Coloproctology, Department of General Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil
,
Rodrigo Ambar Pinto
5   Department of Surgery of the Digestive Systemand Coloproctology, Faculty of Medicine, Hospital das Clínicas, Universidade de São Paulo, São Paulo, SP, Brazil
,
Laercio Robles
2   Department of General Surgery, Service of Colon and Rectal Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil
6   Services of General Surgery and Coloproctology, Department of General Surgery, Hospital Santa Marcelina, São Paulo, SP, Brazil
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Abstract

Introduction Appendicitis is the surgical disease with the highest prevalence in emergency rooms. Its clinical and/or surgical complications are associated with the time course of symptoms, age, comorbidities, and stages of the disease.

Objectives To analyze the demographic and clinical data of patients who underwent appendectomy for acute appendicitis in a tertiary referral hospital in the city of São Paulo and compare these data between services provided by the Public and Supplementary Health System.

Methodology Retrospective analysis of data from electronic medical records of patients over 14 years old who underwent appendectomy for acute appendicitis at Hospital Santa Marcelina, both in the Public and Supplementary Health Systems from January 2015 to December 2017.

Results A total of 536 patients were analyzed, 354 (66%) of whom were male with a general mean age of 29.85 years (14–81 years). The mean time from symptoms to seeking medical care was 53.84 hours. Regarding the phases of acute appendicitis, a greater number of cases of complicated disease was observed in patients operated on in the Public Health System (p < 0.0001), as well as the time course of symptoms (p = 0.0005) and hospitalization (p = 0.0012). On the other hand, the surgical wound infection rate during the hospitalization period was similar between groups (p = 0.2118).

Conclusion There was a predominance of male patients undergoing appendectomy for acute appendicitis, with longer time course of symptoms in those operated on in the Public Health System and a predominance of appendicitis in advanced stages (3 and 4) in this group. However, in this group there was no significant increase in the rate of postoperative infection, and the length of stay was shorter than that of patients operated on in the Supplementary Health System.

Keywords

acute appendicitis - surgical treatment - public health system - supplementary health system


Publication History

Received: 11 September 2023

Accepted: 10 January 2024

Article published online:
11 March 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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