Negative appendectomy: a 3-year hospital-based cross-sectional study from Northern Tanzania

Background: Despite technological advancements in clinical medicine, the diagnosis of acute appendicitis remains a challenge owing to its divergent presentation. For years, the Alvarado score has been the mainstay for the clinical diagnosis of appendicitis; however, it has led to a high negative appendectomy rate (NAR) with post-appendectomy consequences. This study aimed to establish a NAR to further improve the diagnosis and management of appendicitis. This study aimed to determine the NAR by evaluating the clinical diagnosis versus histological correlations in post-appendectomy patients in northern Tanzania. Materials and Methods: This hospital-based cross-sectional study was conducted between March 2020 and March 2023 at a referral hospital in northern Tanzania. Data were extracted from patient records to assess the clinical Alvarado score and were compared to histological findings to determine the NAR. Results: A total of 99 participants were enrolled in the study, with mean age of 33.2 years (± 18 years), and the NAR was 12.5%, highest in females (8%) compared to males (4.5%). Histology confirmed appendicitis in 85 patients (85.9%). Conclusion: NAR remains a burden globally, with an acceptable value of 20%. This study showed a reduction in NAR at our institute using various diagnostic modalities. NAR should be incorporated as a quality metric to judge institutional performance and reduce morbidity and mortality.