Comparison of perforation risk among physicians, other medical professionals and general adults with acute appendicitis in Taiwan

Background: This study aimed to compare the risk of appendiceal perforation among physicians, other medical professionals and general adults, when hospitalized for acute appendicitis. Methods: National population-based data for 92 143 patients with acute appendicitis, aged 20 years or more, who underwent appendicectomy or drainage of an appendiceal abscess in Taiwan from 1996 to 2001 were analysed retrospectively. The outcome measure was appendiceal perforation. Patients were categorized as physicians (Western medical doctors), other medical professionals (such as dentists or nurses) or general adults (not medical professionals). Adjusted odds ratios and 95 per cent confidence intervals (c.i.) were estimated by multiple logistic regression. Results: Multivariable analysis showed that appendiceal perforation was 0.67 (95 per cent c.i. 0.46 to 0.96) and 0.78 (95 per cent c.i. 0.62 to 0.99) times less likely in physicians and other medical professionals respectively than in general adults, after adjusting for patient and admitting hospital characteristics, and for calendar year. Conclusion: The risk of perforation was significantly lower among physicians and other medical professionals than in general adults. Medical knowledge, familiarity with the Healthcare system and better patient-doctor communication may have been contributory factors.