# Negative Appendectomy Rates and Their Correlation With the Use of Histopathology: A Clinical Audit

## TL;DR

This study examines how often appendectomies are performed unnecessarily and finds that younger and female patients are more likely to be affected.

## Contribution

The study provides insights into negative appendectomy rates and correlates them with patient demographics and histopathology use.

## Key findings

- The negative appendectomy rate was less than 5% in the study.
- Younger patients (age ≤ 35 years) and females were more likely to have normal appendices.
- Histopathology confirmed 89% of cases as acute appendicitis.

## Abstract

Objectives

To analyze the rate of negative appendectomies in a tertiary care hospital through assessment of the clinical diagnostic skills of surgical residents while keeping the histopathology report as the gold standard.

Methodology

This clinical audit was conducted at the Surgical ‘C’ Unit of Khyber Teaching Hospital in Peshawar. The study spanned a six-month period (1st of July 2024 to 31st of December 2024). A sample size of 100 patients (both genders) was selected through a non-probability consecutive sampling technique. All patients with a histopathological report of a normal appendix (peri-appendicitis) and appendicitis were identified and included. All the data collected through the fulfillment of proformas were added to a Microsoft Excel® (Microsoft, Redmond, WA, USA) sheet and transferred to SPSS version 23.0 (IBM Corp., Armonk, NY, USA) for data analysis and verification. The results are illustrated in the form of description tables, charts, and figures.

Results

Out of 100 patients who were included in the audit cycle, during the six-month period, 37 (37%) were female patients and 63 (63%) were male patients. Most patients were 20-30 years of age with a mean age of 22.4 ± 0.871. According to the histopathology reports obtained, 89 (89%) patients had acute appendicitis, 6 (6%) patients had gangrenous appendicitis, and 5 (5%) patients had periappendicitis (normal appendix).

Conclusion

The negative appendectomy rate was less than 5% in this study. Female and younger patients (age ≤ 35 years) should be of great concern because they may increase the negative appendectomy rate.