Agreement between surgical and histopathological findings in patients with acute appendicitis at a level III hospital in Bogotá, Colombia
DOI:
https://doi.org/10.30944/20117582.453Palabras clave:
appendicitis, anatomy & histology, observer variation, surgical procedures, operative, pathology, surgicalResumen
Introduction. Currently surgical findings dictate the post-operative treatment of patients with acute appendicitis; however, this relies only on the judgement of the surgeon during the appendectomy. This study aimed to determine the inter-rater reliability between surgeons and pathologists at a tertiary hospital.
Methods. This was a cross-sectional retrospective study conducted between October 2015 and October 2016 at the Central Military Hospital in Bogotá. Patients who underwent appendectomy due to suspected acute appendicitis and had histopathological with their respective surgical findings were included. Our aim was to determine the agreement between surgical and pathology reports.
Results. During the study period, we identified 418 patients who underwent appendectomy. Surgeons assessed 32 (7.77%) appendix as negative, 78 (18.93%) as inflamed, 110 (26.7%) as suppurative, 137 (33.25%) gangrenous and 55 (13.35%) as perforated. Highest agreement was observed in patients with suppurative appendicitis (82/110; 74.5%). Overall Kappa indicated a poor-fair agreement between the pathologist and surgeons (Kappa = 0.2950, 95% CI 0.2384-035.17, p < 0.0001).
Conclusion. There is a poor concordance between surgical and pathologic findings in our study, which is similar to previous articles. As a take home message, surgeons and pathologist should revise the definition of the clinical and the histopathological criteria to better describe the findings and reach a better agreement.
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