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Is acute appendicitis more severe in foreign workers of northern Israel? A retrospective cohort study

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European Journal of Trauma and Emergency Surgery Aims and scope Submit manuscript

Abstract

Background

Acute appendicitis (AA) is one of the most common surgical emergencies worldwide. It’s classified into simple or complicated disease. Due to the high prevalence of the disease, AA has been studied as a marker to assess the quality of care afforded to minority groups. The purpose of this study was to compare AA outcomes in foreign workers (FW) to the general population in northern Israel.

Methods

This is a retrospective cohort study. We identified all patients aged 18–50 who were admitted to our institution between January 1st, 2013 and October 31st, 2018, with the diagnosis of acute appendicitis. The study group included all FW and the control group included citizens of Israel. Study patients were matched based on age, sex, and co-morbidities. We compared time to presentation, admission parameters and disease outcomes. Our study outcomes were disease severity and length of hospital stay.

Results

We identified 20 FW and 97 matched local patients. FW presented with significantly higher heart rate, temperature, and white blood cell count (WBC). Duration of symptoms was comparable between the two groups. The rates of complicated disease were significantly higher among FW (45 vs 17.5%, p < 0.0001). Length of hospitalization was significantly longer in the FW group (4.8 vs. 3.9 days, p = 0.01). The odds ratio of FWs for having a complicated disease was OR = 3.85 [95% CI: 1.38, 10.72], p = 0.01. Multivariate analysis identified FW and duration of symptoms as significantly contributing to a complicated disease outcome.

Conclusions

Although duration of symptoms was comparable to the local population, FW in northern Israel are at increased risk for a complicated disease which resulted in longer hospital stay. Further studies may enlighten the reason for this disparity.

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Authors and Affiliations

  1. Department of General Surgery, Ziv Medical Center, Rambam St, 13100, Zefat, Israel

    Chovav Handler

  2. Department of General Surgery B., Emek Medical Center, Yitshak Rabin Boulevard 21, 1834111, Afula, Israel

    Noam Weiner, Eyal Meir, Ossama Abu-Hatoum, Doron Kopelman & Uri Kaplan

  3. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Efron st. 1, Bat Galim, 3525433, Haifa, Israel

    Ossama Abu-Hatoum, Doron Kopelman & Uri Kaplan

Authors
  1. Chovav Handler
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  2. Noam Weiner
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  3. Eyal Meir
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  4. Ossama Abu-Hatoum
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  5. Doron Kopelman
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Correspondence to Uri Kaplan.

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Handler, C., Weiner, N., Meir, E. et al. Is acute appendicitis more severe in foreign workers of northern Israel? A retrospective cohort study. Eur J Trauma Emerg Surg 49, 2235–2240 (2023). https://doi.org/10.1007/s00068-022-01980-5

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  • DOI: https://doi.org/10.1007/s00068-022-01980-5

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