The importance of physician speciality on the diagnosis of acute appendicitis and its effect on morbidity in children

• Published in: Journal of paediatrics and child health Vol. 58; no. 11; pp. 2003 - 2007
• Main Authors: Bostancı, Süleyman A, Şenel, Emrah
• Format: Journal Article
• Language: English
• Published: Australia John Wiley & Sons Australia, Ltd 01-11-2022; Blackwell Publishing Ltd
• Subjects: Abdominal Pain - diagnosis; Abdominal Pain - etiology; acute appendicitis; Acute Disease; Appendectomy - adverse effects; Appendicitis; Appendicitis - diagnosis; Appendicitis - surgery; Child; children; Clinical competence; Humans; Medical diagnosis; Medical errors; misdiagnosis; Morbidity; Pediatrics; Physicians; Postoperative Complications - diagnosis; Postoperative Complications - epidemiology; Postoperative Complications - etiology; Retrospective Studies; Specialists; acute appendicitis; children; misdiagnosis
• ISSN: 1034-4810; 1440-1754
• DOI: 10.1111/jpc.16138

Aim
Most acute appendicitis (AA) patients present first to physicians who are not paediatric surgeons. The aim of this study was to investigate whether there is a relationship between the speciality of the first physician and delays in diagnosis and morbidity in AA.
Methods
The study was planned prospectively. Patients who were operated on between 15 June 2017 and 2018 due to abdominal pain were included. Demographic data of the patients, speciality of the doctors who examined them and postoperative complications were recorded. The patients were divided into three groups: those who were diagnosed at the first examination, those who were diagnosed at the second examination and those who were diagnosed after three or more examinations.
Results
A total of 414 patients were included in the study. There were 255 (61.6%) patients in group 1, 135 (32.6%) patients in group 2 and 24 (5.8%) patients in group 3. The mean age of the patients in group 3 was lower (P < 0.05). Postoperative complications and hospital stay were higher in group 3 (P < 0.05). While 91.8% of the patients in group 1 were examined by a paediatrician, this rate was significantly lower in the other groups (P < 0.05).
Conclusions
If children presenting with abdominal pain are evaluated primarily by paediatricians, consultation with paediatric surgeons is faster. The awareness of doctors of other specialities should be increased through regular periodic training.