Post appendectomy complications and associated factors among children in Amhara region, ethiopia: Multi-center retrospective follow up study.

introductionPost-operative complication is an unfavorable outcome. The frequency of post-operative complication following appendectomy ranges from 5.2 to 29.3%. Despite this magnitude, the epidemiological statuses of post-appendectomy complications studies in children are limited in the study area. Therefore, this study aims to assess the incidence of post-operative complications and associated factors among children underwent appendectomy in Amhara region, Ethiopia.

methodsA retrospective follows-up study undertaken among children who experienced appendectomy. The data extraction tool was used to collect data from 423 sampled participants. Simple random sampling technique was used. The data was presented using table, graphs and text forms. The data was also summarized by median, proportion and frequency depends on the data type. Kaplan-Meier survival curve and Log rank test were also used to estimate median survival time and to compare the overall survival experience of two or more groups. The Cox Proportional Hazard model was fitted to identify predictors of post-operative complications. Any statistical test considered significant at P-value < 0.05.

resultA total of 406 study participants were included for analysis. The over-all cumulative incidence of post-operative complication following appencectomy was 16.04, 95% CI (13.12, 19.61) per 1000 Person Day Observations with 5924 person-days of follow-up. The median postoperative complication free survival time was also 11 days after appendectomy. Being rural residence (AHR = 2.3, 95%CI: (1.4, 3.7)), having uncomplicated appendicitis at presentation (AHR = 2.1, 95%CI: (1.3, 3.3)), waiting for greater than 24 h in hospital (AHR = 0.5, 95%CI (0.3, 0.7)) and taking preoperative antibiotics (AHR = 0.3, 95%CI: ( 0.1, 0.5)) were statistically significant predictors of post appendectomy complication in children. CONCLUSION AND RECOMMENDATION: The incidence of post appendectomy complication is high. Being rural in residence, presented with complicated appendicitis, waiting for more than 24 h and taking preoperative antibiotics were found to be statistically significant predictors of post appendectomy complication in children. A further prospective cohort study in consideration of some clinical variables such as C-reactive protein, sodium level and calprotectin might be important. The clinicians detailed attention on children who are rural residence, suspecting complicated appendicitis before the procedure and ensuring preoperative antibiotic administration is also important.