HIGH NEGATIVE APPENDECTOMY RATES ARE NO LONGER ACCEPTABLE

BACKGROUND: A 10% to 20% negative appendectomy rate has been accepted in order to minimize the incidence of perforated appendicitis with its increased morbidity. We reviewed our experience with appendicitis in order to determine the incidence of negative appendectomies and perfor ation, and the role of delay in diagnosis or treatment. METHODS: We re viewed 659 appendectomies performed over a 12-month period. incidental and pediatric appendectomies were excluded. RESULTS: Seventy-five per cent of patients were male and 25% female. Nine percent had negative a ppendectomies and 28% had perforated appendicitis. Perforated appendic itis resulted in increased morbidity and length of stay. Delay in pres entation greater than 12 hours after the onset of symptoms significant ly increased the perforation rate. In-hospital delay did not affect pe rforation rate.CONCLUSIONS: We have achieved a negative appendectomy r ate lower than that in other reported series, while maintaining-an acc eptable perforation rate. In the majority of patients, perforated appe ndicitis is a result of late presentation. (C) 1997 by Excerpta Medica , Inc.