Preserved Throughput, Hidden Strain: Emergency Appendectomy After a Major Earthquake

Background This study aimed to evaluate the clinical characteristics, imaging accuracy, and postoperative outcomes of acute appendicitis before and after a major earthquake. Methods We retrospectively analyzed 810 appendectomies performed between August 2021 and August 2024, stratified into pre- (n = 436) and post-earthquake (n = 374) groups based on the February 6, 2023, earthquake. The study population was restricted to patients who underwent appendectomy, reflecting the clinical outcomes of an operatively managed cohort. Complicated appendicitis was defined based on the postoperative histopathological examination. Pre- and post-earthquake groups were compared using appropriate statistical tests, and logistic regression analysis was performed to identify the factors associated with complicated appendicitis. Results The incidence of complicated appendicitis did not differ significantly between the pre- and post-earthquake groups (9.1% vs 10.8%, P = .429). Postoperative complications were significantly more frequent in the post-earthquake cohort ( P < .001), with a notable increase in Clavien-Dindo Grade II events (19.0% vs 5.3%) despite a higher proportion of ASA I individuals. Regarding laboratory parameters, platelet counts were higher in the post-earthquake group (263.5 vs 247.6 × 10 3 /µL, P = .001), while elevated C-reactive protein levels were the sole independent predictor of complicated appendicitis (OR: 3.98, P = .025). Conclusion The rates of complicated appendicitis remained stable following the earthquake, confirming the preservation of emergency surgical capacity. However, systemic strain was associated with increased minor postoperative morbidity. In an institution maintaining a primary operative approach, these findings demonstrate that sustaining emergency surgical throughput under disaster conditions entails subtle operational frictions, even when surgical access is fully maintained.