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KMID : 0356019860010010027
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Koean Jounral of Critical Care Medicine
1986 Volume.1 No. 1 p.27 ~ p.37
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A Study on the Educational Level of Patients and the Clinica1 Course of Acute Appendicitis
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Abstract
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Acute appendicitis can be easily treated by early diagnosis and surgery. But in case with perforation resulting from the delay in diagnosis or surgery, although the mortality has been reduced markedly by the effective therapy with antibiotics and intensive pre- and postoperative management, problems including serious complications. And the proIonged hosp- ital stay with increased hospital expense occur very often.
The author reviewed 360 cases of appendicitis admitted. To the Department of Surgery, Hanyang University Hospital from July 198I to June 1982 and investigated their hospital course and expenses, the patients educational background and knowledges on health. The result was as follows.
1) The incidence of the perforation of acute appendicitis was 26. 9%, resulting from the delay in diagnosis and surgery.
2) Perforation occurred in 68. 1% of cases operated later than 48 hours of the appearance of symptom.
3) The rate of wrong diagnosis (rnistaking other conditions for appendicitis) was 13.8%
4) The frequency of delayed operation was 13.5% in the group of patients visited Hanyang University Hospital at first. Among those who missed the opportunity of early operation, the largest group of patients wasted time only by taking medicine purchased at drug stores
5) Average length of hospital stay of the nonperforated and perforated group were 6. 0 and. 12. 2 days respectively.
6) The overall incidence of postoperative complications of appendectomy was 16.4%; 0.5%; of the nonperforated and 46. 4% of the perforated.
7) The higher was the educational level of the patient, the lower the incidence of perfo- ration was.
8) As for the choice of medical facilities by the patient with appendicitis, the highly edu- cated group showed a tendency to visit hospital first while the majority of those having lower educational background first visited drug store. 9) The result of survey through quetionnaire(for the student of schools of various level) was somewhat different. To the question asking what kind of medical facility they should prefer to visit firstly when they have acute abdomen, the tendency to prefer a hospital to a durg store decreased the level of schooling advanced.
10) Innonperforated group, the cost of surgical operation occupied the largest proportion of the total expense whereas, in perforated group, the largest one was the cost of medication.
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