Is language disability a risk factor for complicated appendicitis? A retrospective cohort study

Aim: Acute appendicitis is the most common emergent surgical disease and complicated appendicitis is an indicator of disrupted access to healthcare. Language disability has become more important in the healthcare sector with increasing migration in the last decade. We aimed to evaluate language disability as a risk factor for complicated appendicitis. Methods: From January 2014 to December 2018, patients who were operated for acute appendicitis were evaluated retrospectively. Patients’ age, gender, language disability (LD) (no (C) or yes (F)), whether surgical drainage was required, pathological findings (appendix diameter, severity as uncomplicated (UCA) or complicated (CA), and presence of local peritonitis), levels of C-Reactive Protein (CRP), White Blood Cells (Wbc), Neutrophil% (Neu%), and ultrasonography (USG) and computed tomography (CT) results were noted and compared. Results: Six hundered twenty-eight patients were included in the study, among which 15.1% (n=95) were considered F, and 12% (n=74) were CA. Age and gender did not significantly differ in terms of LD and severity (P=0.15, P=0.24 and P=0.2, P=0.21, respectively). Drainage requirement, local peritonitis, levels of CRP, Wbc, and Neu% were significantly higher in the CA group (P<0.001, P<0.001, P<0.001, P=0.009, and P<0.001, respectively). Drainage, appendix diameter, levels of CRP, and Neu% were significantly higher in the F group (P=0.01, P=0.04, P=0.007, and P=0.046, respectively). CA rate was insignificantly higher in the F group (17% vs 11%) (P=0.72). The false-negative ratio of USG and CT was higher in F patients with CA (56.2% vs. 37.5%). Conclusion: This study showed that language disability could be a risk factor for complicated appendicitis with higher drainage ratio, appendix diameter, levels of CRP, and Neu%.