Resumen

CASADO MENDEZ, Pedro Rafael et al. Evaluation of the quality of the diagnosis of acute appendicitis in the primary and secondary care. AMC [online]. 2016, vol.20, n.1, pp.25-35. ISSN 1025-0255.

Background: acute appendicitis is the tracer disease of non-traumatic acute abdomen. Its overdiagnosis is a matter of concern in clinical medicine. Objective: to evaluate the quality of the diagnosis of acute appendicitis in the primary and secondary care. Methods: a quantitative, prospective, observational and descriptive study with analytical facets was conducted. The clinical, operating and histopathological diagnoses were evaluated in a universe of 200 patients referred by the primary care to the general surgery department of Celia Sanchez Manduley Provincial Hospital, Manzanillo, Granma with the diagnosis of acute appendicitis in a period of five months, from November, 2014 to March, 2015. Results: male sex (60, 5 %), the 21 to 25 age group, and the catarrhal pathoanatomical stage (28, 68 %) predominated. The clinical correlation between both health care services was of 79 %. The diagnostic correlation between the clinical and the operating diagnoses, between the clinical and histopathological diagnoses and between the operating and the histopathological diagnoses was of 81, 65 %; 68, 35 % and 83, 72 % respectively in the secondary care. The diagnostic effectiveness was lower for general doctors (26, 03 %) and higher for specialists in general surgery (71, 93 %). Conclusion: the quality of the diagnosis of acute appendicitis in the primary care was unsatisfactory and although it improved in the secondary care, the parameters of effectiveness were not yet satisfactory. There is a lack of clinical parameters that provide diagnostic certainty; however, clinical medicine is still the base in decision-making.

Palabras clave : APPENDICITIS [diagnosis]; DIAGNOSIS; QUALITY MANAGEMENT; SECONDARY CARE; QUANTITATIVE ANALYSIS.

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