Coelho Júlio C U, Fernandes Fabiana Marques, Cortiano Luís Gustavo G, Leme Gustavo Munhoz de Oliveira, Sadowski José Alfredo, Artner Christian Luiz
Serviço de Cirurgia do Aparelho Digestivo e Transplante Hepático, Hospital de Clínica, Universidade Federal do Paraná, Curitiba, PR.
Rev Assoc Med Bras (1992). 2010 Sep-Oct;56(5):522-7. doi: 10.1590/s0104-42302010000500011.
The aim of this study is to compare data of patients submitted to appendectomy for acute appendicitis at a public hospital and at a private hospital.
A total of 200 medical records of patients submitted to appendectomy for acute appendicitis at a public hospital (n=100) and at a private hospital (n=100), was reviewed retrospectively.
Mean age and gender distribution were similar for patients of both hospitals. More patients had been previously evaluated by other physicians in the group of the public hospital (n=85) than of the private hospital (n=13) (p< 0.0001). Ultrasonography was performed more frequently on patients of the public hospital (n=56) than of the private hospital (n=30) (p=0.0002). Length of hospital stay was longer at the public hospital (3.5 ± 2.8 days) than at the private hospital (2.5 ± 1.7 days) (p=0.0024). Postoperative complications were more frequent at the public hospital (n=36) than at the private hospital (n=20) (p<0.0117). Time to resume routine activities was longer for the public hospital (33.2 ± 8.3 days) than for the private hospital (16.4 ± 5.2 days) (p<0.0001). Multivariate logistic-regression analysis showed that the estimated probability of complicated appendicitis increased with the time interval between onset of symptoms and appendectomy (p<0.001). Independent risk factor associated with complicated appendicitis was the time interval between onset of symptoms and appendectomy (odds ratio 41.65, 95% CI {confidence interval} 2.90-597.49, p<0.0001) at the public hospital. There was no independent risk factor associated with complicated appendicitis at the private hospital.
There are important differences between public and private hospitals in the diagnosis and outcomes of patients with acute appendicitis submitted to appendectomy.
本研究旨在比较在公立医院和私立医院接受急性阑尾炎阑尾切除术患者的数据。
回顾性分析了200例在公立医院（n = 100）和私立医院（n = 100）接受急性阑尾炎阑尾切除术患者的病历。
两家医院患者的平均年龄和性别分布相似。公立医院组（n = 85）中曾由其他医生进行过评估的患者比私立医院组（n = 13）更多（p < 0.0001）。公立医院患者（n = 56）接受超声检查的频率高于私立医院患者（n = 30）（p = 0.0002）。公立医院的住院时间（3.5 ± 2.8天）比私立医院（2.5 ± 1.7天）更长（p = 0.0024）。公立医院的术后并发症（n = 36）比私立医院（n = 20）更常见（p < 0.0117）。公立医院恢复日常活动的时间（33.2 ± 8.3天）比私立医院（16.4 ± 5.2天）更长（p < 0.0001）。多因素逻辑回归分析显示，复杂性阑尾炎的估计概率随症状出现与阑尾切除术之间的时间间隔增加而增加（p < 0.001）。在公立医院，与复杂性阑尾炎相关的独立危险因素是症状出现与阑尾切除术之间的时间间隔（比值比41.65，95%置信区间2.90 - 597.49，p < 0.0001）。私立医院没有与复杂性阑尾炎相关的独立危险因素。
在接受阑尾切除术的急性阑尾炎患者的诊断和治疗结果方面，公立医院和私立医院存在重要差异。
