EFFECT OF GENDER ON DELAYED DIAGNOSIS OF ACUTE APPENDICITIS

Abstract

Background: Acute appendicitis is a common surgical emergency requiring timely diagnosis to prevent complications such as perforation and abscess formation. Despite advancements in diagnostic techniques, variations in presentation and healthcare access contribute to delays, particularly in certain demographic groups. Gender-based disparities in the evaluation and management of acute appendicitis have been observed, with female patients often experiencing extended diagnostic timelines. Understanding these disparities is essential for optimizing patient outcomes and reducing morbidity associated with delayed intervention.

Objective: To evaluate the effect of gender on the delayed diagnosis of acute appendicitis.

Methods: This cross-sectional analytical study was conducted over six months at Combined Military Hospital, Quetta. A total of 338 patients diagnosed with acute appendicitis and undergoing appendectomy between March and August 2023 were included through non-probability consecutive sampling. Patients aged 12 years or older of either gender who presented with symptoms suggestive of acute appendicitis were enrolled. Those who were pregnant, immunocompromised, or had a clinically palpable appendicular mass were excluded. The primary outcome was delayed diagnosis, defined as a time from presentation to surgery exceeding 24 hours. Data analysis was performed using IBM SPSS version 26.0, with a p-value of <0.05 considered statistically significant.

Results: Among 338 patients, 182 (53.8%) were male and 156 (46.1%) were female, with an overall age range of 12–70 years and a mean age of 33.90 ± 15.60 years. A total of 250 (73.97%) patients were classified into the non-delayed group (≤24 hours), while 88 (26.03%) were categorized into the delayed group (>24 hours). Males comprised 145 (58.0%) of the non-delayed group and 37 (42.04%) of the delayed group, while females accounted for 105 (42.0%) and 41 (46.59%), respectively. A statistically significant association was found between gender and delayed diagnosis (p < 0.05), with females experiencing longer diagnostic delays.

Conclusion: The study identified significant gender-based disparities in the delayed diagnosis of acute appendicitis, with female patients experiencing greater delays than males. These findings emphasize the need for heightened clinical awareness and standardized diagnostic protocols to minimize delays, particularly in women, thereby reducing associated complications and improving patient outcomes.