Appendectomy: comparative study between a public and a private hospital

• Autor(a) principal: Coelho,Júlio C. U
• Data de Publicação: 2010
• Outros Autores: Fernandes,Fabiana Marques, Cortiano,Luís Gustavo G, Leme,Gustavo Munhoz de Oliveira, Sadowski,José Alfredo, Artner,Christian Luiz
• Tipo de documento: Artigo
• Idioma: eng
• Título da fonte: Revista da Associação Médica Brasileira (Online)
• Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0104-42302010000500011
• topic: Socioeconomic factors; Appendicitis; Appendectomy; Health insurance; Postoperative complications

OBJECTIVE: The aim of this study is to compare data of patients submitted to appendectomy for acute appendicitis at a public hospital and at a private hospital. METHODS: A total of 200 medical records of patients submitted to appendectomy for acute appendicitis at a public hospital (n=100) and at a private hospital (n=100), was reviewed retrospectively. RESULTS: Mean age and gender distribution were similar for patients of both hospitals. More patients had been previously evaluated by other physicians in the group of the public hospital (n=85) than of the private hospital (n=13) (p< 0.0001). Ultrasonography was performed more frequently on patients of the public hospital (n=56) than of the private hospital (n=30) (p=0.0002). Length of hospital stay was longer at the public hospital (3.5±2.8 days) than at the private hospital (2.5±1.7 days) (p=0.0024). Postoperative complications were more frequent at the public hospital (n=36) than at the private hospital (n=20) (p<0.0117). Time to resume routine activities was longer for the public hospital (33.2±8.3 days) than for the private hospital (16.4±5.2 days) (p<0.0001). Multivariate logistic-regression analysis showed that the estimated probability of complicated appendicitis increased with the time interval between onset of symptoms and appendectomy (p<0.001). Independent risk factor associated with complicated appendicitis was the time interval between onset of symptoms and appendectomy (odds ratio 41.65, 95% CI {confidence interval} 2.90-597.49, p<0.0001) at the public hospital. There was no independent risk factor associated with complicated appendicitis at the private hospital. CONCLUSION:There are important differences between public and private hospitals in the diagnosis and outcomes of patients with acute appendicitis submitted to appendectomy.