INCIDENCE OF NEGATIVE APPENDECTOMIES IN A TERTIARY CARE HOSPITAL
Keywords:
Acute appendicitis, Negative appendectomy, Alvarado score, Histopathology, Preoperative diagnosis, Tertiary care, Surgical outcomesAbstract
Background: Acute appendicitis is a common surgical emergency, yet negative appendectomy rates remain high despite clinical scoring and imaging. This study evaluated the frequency of negative appendectomies in a tertiary care hospital in Peshawar.
Methods: A prospective cross-sectional study was conducted at Holy Family Hospital from October 2024 to February 2025. A total of 305 patients aged 18–60 years, clinically diagnosed with acute appendicitis (Alvarado score ≥7) and, when needed, confirmed by ultrasound, underwent open appendectomy. Histopathology was used as the diagnostic gold standard.
Results: Negative appendectomies occurred in 31 patients (10.2%), with women showing a higher rate than men (13.4% vs. 7.1%, p < 0.05). Mean Alvarado scores were significantly lower in the negative group (6.4 ± 1.0) compared to the positive group (8.1 ± 1.1, p = 0.001).
Conclusion: A 10.2% negative appendectomy rate highlights the need for improved preoperative diagnostics. Refining clinical scoring thresholds and selectively employing advanced imaging can help reduce unnecessary surgeries.
