Department of General Surgery, Ziv Medical Center, Rambam St, 13100, Zefat, Israel.
Department of General Surgery B., Emek Medical Center, Yitshak Rabin Boulevard 21, 1834111, Afula, Israel.
Eur J Trauma Emerg Surg. 2023 Oct;49(5):2235-2240. doi: 10.1007/s00068-022-01980-5. Epub 2022 May 7.
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.
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.
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.
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.
急性阑尾炎（AA）是全球最常见的外科急症之一。它分为单纯性或复杂性疾病。由于该病的高患病率，AA 已被研究作为评估少数族裔群体所获得医疗服务质量的指标。本研究的目的是比较以色列北部外国工人（FW）与普通人群的 AA 结局。
这是一项回顾性队列研究。我们确定了所有在 2013 年 1 月 1 日至 2018 年 10 月 31 日期间因急性阑尾炎入院的 18-50 岁患者。研究组包括所有 FW，对照组包括以色列公民。根据年龄、性别和合并症对研究患者进行匹配。我们比较了就诊时间、入院参数和疾病结局。我们的研究结局是疾病严重程度和住院时间。
我们确定了 20 名 FW 和 97 名匹配的本地患者。FW 的心率、体温和白细胞计数（WBC）明显更高。两组的症状持续时间相似。FW 中复杂疾病的发生率明显更高（45%比 17.5%，p<0.0001）。FW 组的住院时间明显更长（4.8 比 3.9 天，p=0.01）。FW 患复杂疾病的比值比（OR）为 3.85[95%CI：1.38, 10.72]，p=0.01。多变量分析表明，FW 和症状持续时间是导致复杂疾病结局的重要因素。
尽管症状持续时间与当地人群相似，但以色列北部的 FW 患复杂疾病的风险增加，导致住院时间延长。进一步的研究可能会阐明这种差异的原因。
