EP.FRI.692 Gender differences in the age and outcomes of appendicectomy patients

Abstract

Aims Appendicectomy is one of the commonest emergency General Surgical operations performed. However, there exists minimal published literature exploring whether there are differences between males and females undergoing appendicectomy. This study aimed to investigate the demographics, pre-operative investigation, intra-operative findings and clinical outcomes between both genders having an emergency appendicectomy. Methods A multicentre retrospective cohort study of all patients who had an emergency appendicectomy within four UK hospitals between September 2019 and November 2020. Electronic records were interrogated and patients dichotomised by gender and the results compared. Results 559 emergency appendicectomies (315 (56.4%) male and 244 (43.6%) female patients) were included. Males undergoing appendicectomy were younger (median age: 33 vs 41 years, p < 0.001). American Society of Anaesthesiologists classification was equally matched. Whilst no difference in mean white cell or neutrophil count was identified, C-reactive protein was lower (mean 108 vs 137, p = 0.001) and bilirubin higher (mean 21 vs 15, p < 0.001) in male patients pre-operatively. Pre-operative imaging was performed more often in females: ultrasound (16.0 vs 1.3%, p < 0.001) and CT scan (69.3 vs 60.3%, p = 0.029). Male patients underwent more open surgery (13.7 vs 8.2%, p = 0.043). The intra-operative severity of appendicitis was equally matched. No differences in overall hospital length of stay (median 3 vs 3 days, p = 0.183), post-operative complication rates or 30-day readmission rates were identified. Conclusions This study demonstrates that differences exist between males and females who have emergency appendicectomy in terms of age, use of pre-operative imaging and operative approach, however, clinical outcomes are similar.