The Relation Between Diagnostic Delay to the Incidence of Perforation in Patients with Acute Appendicitis at Rumah Sakit Dustira in 2016-2020
Lukmana Lokarjana (a*), Sony Ramdhani (b), Atha Aurellia Adinata (c), Andri Anugrah (a)

a) Department of Surgery, Faculty of Medicine, Jenderal Achmad Yani University, Cimahi. Indonesia
* lukmanalokarjana[at]gmail.com
b) Department of Forensics and Medicolegal, Faculty of Medicine, Jenderal Achmad Yani University, Cimahi. Indonesia
c) Faculty of Medicine, Jenderal Achmad Yani University, Cimahi. Indonesia

Abstract

Acute appendicitis is an inflammation of appendix, leading to perforation with prevalence of 30-70%. Mortality rate of perforation multiplies 3,5-10 times. It is necessary to diagnose perforation pre-operation. Signs and symptoms of perforation manifest in the first 12 hours, it is possible to prevent perforation by considering diagnostic time, expecting an improvement in prognosis. Research was conducted at Rumah Sakit Dustira in 2017-2020 to determine the relationship between diagnostic delay to the incidence of perforation in patients with acute appendicitis at Rumah Sakit Dustira in 2017-2020. Research used medical records on patients >18 years diagnosed with acute appendicitis and underwent appendectomy at Rumah Sakit Dustira in 2017-2020. This was an analytical research with cross-sectional approach, data was collected using non probability and purposive sampling. The minimum sampling determination using hypothesis testing for two sample proportions formula, resulting in 21 samples. Data was analyzed in univariate and bivariate. The research^s results showed there is no relation between diagnostic delay and the incidence of perforation in patients with acute appendicitis (p-value 0,229>0,05) using Fisher^s Exact test, there is no significant difference between diagnostic time of patients with perforation and without perforation (p-value 0,984>0,05) using Mann-Whitney test. There were 24 patients (80%) with delayed diagnosis and appendix perforation. Prevalence ratio was 1,6, explaining perforation occurred more in patients with diagnostic delay. It is concluded that diagnostic delay is not related to the incidence of perforation in patients with acute appendicitis. Upcoming research could categorize diagnostic time into <24, 24-72, and >72 hours.

Keywords: Acute appendicitis, Diagnostic delay, Perforation of appendix

Topic: Clinical Practice