GENDER DIFFERENCES IN DIAGNOSIS AND PERIOPERATIVE OUTCOMES AMONG ADULT PATIENTS WITH ACUTE APPENDICITIS sbertona@hospitalaleman.com

195-04

GENDER DIFFERENCES IN DIAGNOSIS AND PERIOPERATIVE OUTCOMES AMONG ADULT PATIENTS WITH ACUTE APPENDICITIS

5

Argentina

Oral only

Acute appendicitis (AA) is the most prevalent surgical emergency worldwide, with a lifetime risk estimated between 7% and 9%. Numerous studies have examined various aspects of AA, including its physiopathology, diagnosis, and treatment options. However, there is limited data addressing differences between patients’ gender, and most of the evidence includes pediatric population with a small number of patients.

Consecutive patients undergoing surgery for acute appendicitis between 2006 and 2023 were included. The cohort was divided into two groups according to biological sex: female sex (FS) and male sex (MS). Demographic, surgical, and postoperative variables were compared.

A total of 2,860 patients were included (47.7% female, 52.3% male). Males had higher rates of hypertension (6.8% vs. 9.7%, p=0.003), coronary disease (0.8% vs. 2.3%, p=0.005), and diabetes (1.7% vs. 2.8%, p=0.04). Time to consultation was similar (40.5 vs. 40.2 h, p=0.91). Diagnosis was mainly by ultrasound (70.9% vs. 71.8%, p=0.55), followed by CT (25.2% vs. 24%, p=0.46). Males showed more complicated appendicitis (24.4% vs. 20.9%, p=0.02) and longer operative time (60 vs. 56 min, p<0.001), while normal appendix was more frequent in females (6% vs. 2.1%, p<0.001). In normal appendix cases, CT use was lower (12.3% vs. 87.7% US, p=0.002). Postoperative infection (1.6% vs. 2.4%, p=0.12), morbidity (13% vs. 13.4%, p=0.68), major morbidity (4.3% vs. 2.7%, p=0.53), abscess (3.6% vs. 4.7%, p=0.15), and hospital stay (1.6 vs. 1.7 days, p=0.46) were similar. No mortality occurred.

Higher negative appendectomy rates in females highlight the need for increased CT use to improve accuracy, outcomes