Relationship Between Forced Migration and Complicated Acute Appendicitis in a National Referral Hospital in Peru
DOI:
https://doi.org/10.15517/rckat816Keywords:
appendicitis, forced migration, risk factorsAbstract
Introduction: Acute Appendicitis is one of the most common surgical emergencies both globally and nationally, with various factors potentially leading to greater complications. This study aims to determine the association between complicated acute appendicitis and forced migration in adults treated at a referral hospital in Peru between 2020 and 2024. Methodology: A quantitative, observational, cross-sectional, analytical, and retrospective study was conducted on a population of patients over 18 years old diagnosed with acute appendicitis. The sample included 690 patients, analyzed according to clinical, demographic, and laboratory variables. Results: The findings showed a significant association between forced migration and complicated acute appendicitis (CAA). The mean age of the patients was 46.11 ± 10.5 years, with a predominance of males (52.9%) and adults (88.4%) in the migrant group, where 73.2% presented CAA. Additionally, forced migration was significantly associated with CAA (adjusted prevalence ratio: 1.14; p = 0.023), as well as a neutrophil-to-lymphocyte ratio ≥ 7.4 and an Alvarado score > 7.5. Conclusions: The results suggest that forced migration is a significant risk factor for the development of complicated acute appendicitis, possibly due to barriers in healthcare access and delayed diagnosis. Therefore, it is recommended to strengthen strategies to improve medical care for migrant populations and reduce these health disparities.
Downloads
References
ACNUR. (s.f.). Estatuto de los Refugiados-1951. https://www.acnur.org/convencion-sobre-el-estatuto-de-los-refugiados-de-1951
ACNUR. (2024). Migrantes y Refugiados. https://www.acnur.org/donde-trabajamos/pais/peru
Al-kassab-Córdova, A., Mendez-Guerra, C., Robles-Valcarcel, P., Bendezu-Quispe, G., & Benites-Zapata, V. A. (2024). Access to HIV/STI testing among male and female Venezuelan migrants in Peru: Evidence from a nationwide survey. BMC Public Health, 24(1), 210. https://doi.org/10.1186/s12889-024-17655-2
Asociación Médica Mundial. (2024). Declaración de Taipei. https://www.wma.net/es/que-hacemos/etica-medica/declaracion-de-taipei/
Bouchard, M. E., Kan, K., Tian, Y., Casale, M., Smith, T., De Boer, C., Linton, S., Abdullah, F., & Ghomrawi, H. M. K. (2022). Association Between Neighborhood-Level Social Determinants of Health and Access to Pediatric Appendicitis Care. JAMA Network Open, 5(2), e2148865. https://doi.org/10.1001/jamanetworkopen.2021.48865
Cehua Alvarez, E., Delgado Garro, A. M., Virú Flores, H. M., Roque Quezada, J. C., Valdiglesias Ochoa, D. J., Nieves Cordova, L. E., y Quezada Gómez, G. (2023). Características epidemiológico-clínicas y resultados del manejo de plastrón apendicular en pacientes adultos de un hospital de referencia del Perú: Epidemiological-clinical characteristics and results of appendiceal plastron management in adult patients from a reference hospital in Peru. Revista de la Facultad de Medicina Humana, 23(1). https://doi.org/10.25176/rfmh.v23i1.5538
Cruz Zárate, A., y Abarca Barriga, H. (2024). Factores asociados a apendicitis aguda complicada en un hospital peruano de emergencias pediátricas. Revista de la Facultad de Medicina Humana, 24(4), 26-34. https://doi.org/10.25176/rfmh.v24i4.5669
Cuschieri, S. (2019). The STROBE guidelines. Saudi Journal of Anaesthesia, 13(5), 31. https://doi.org/10.4103/sja.SJA_543_18
Durmuş, A. Ç., Mehmet, P., Tufan, G., & Hasan, E. (2021). Does Being a Refugee Increase the Possibility of Complicated Appendicitis? Iranian Red Crescent Medical Journal, 23(9). https://doi.org/10.32592/ircmj.2021.23.9.833
Eren, S. K., & Dönder, Y. (2022). Comparison of complicated appendicitis rates between refugees and local patients. Turkish Journal of Trauma & Emergency Surgery, 28(1), 62-68. https://doi.org/10.14744/tjtes.2020.70025
Fondo de las Naciones Unidas para la Infancia. (2022). Refugiados en el Perú. https://www.unicef.org/peru/comunicados-prensa/personas-refugiadas-oportunidad-para-peru
Global Compact on Refugees. (s.f.). Access to national services for vulnerable refugees in Peru. http://globalcompactrefugees.org/good-practices/access-national-services-vulnerable-refugees-peru
Guan, L., Liu, Z., Pan, G., Zhang, B., Wu, Y., Gan, T., & Ouyang, G. (2023). The global, regional, and national burden of appendicitis in 204 countries and territories, 1990-2019: A systematic analysis from the Global Burden of Disease Study 2019. BMC Gastroenterology, 23, 44. https://doi.org/10.1186/s12876-023-02678-7
Guevara Castro, L., Alburqueque Melgarejo, J., Viru Flores, H., De La Cruz Vargas, J., Roque Quezada, J., y Herrera Matta, J. (2022). Índice neutrófilo linfocito un marcador predictivo para el diagnóstico de apendicitis aguda complicada. Revista de Cirugía, 74(5). http://dx.doi.org/10.35687/s2452-454920220051525
Hart, S. (2025). Lack of Access to Quality Healthcare in Peru. Ballard Brief. https://ballardbrief.byu.edu/issue-briefs/lack-of-access-to-quality-healthcare-in-peru
Instituto Nacional de Estadística e Informática. (2025a). Cobertura de Asegurados en el Perú. https://www.gob.pe/institucion/inei/noticias/1129447-mas-del-90-0-de-la-poblacion-del-pais-cuenta-con-algun-seguro-de-salud
Instituto Nacional de Estadística e Informática. (2025b). Ingreso de extranjeros. https://www.gob.pe/institucion/inei/noticias/1070023-ingreso-de-extranjeros-al-peru-aumento-18-2-en-el-tercer-trimestre-de-2024
International Organization for Migration. (s.f.). Migration and Migrants: Regional Dimensions and Developments. https://worldmigrationreport.iom.int/what-we-do/world-migration-report-2024-chapter-3/latin-america-and-caribbean
International Organization for Migration. (2025). Miles de migrantes en Perú. https://peru.iom.int/es/news/miles-de-migrantes-en-peru-recibieron-asistencia-humanitaria-gracias-oim-y-al-gobierno-de-la-republica-de-corea
Ju, J.-J., Zhang, T., Cheng, Y., Zhou, Y.-L., Qi, S.-Q., Zhang, Z.-Q., Shen, W.-C., & Pan, Z.-B. (2024). Risk factors for acute complicated appendicitis in children aged three years and younger. BMC Pediatrics, 24(1), 484. https://doi.org/10.1186/s12887-024-04959-w
Krzyzak, M., & Mulrooney, S. M. (2020). Acute Appendicitis Review: Background, Epidemiology, Diagnosis, and Treatment. Cureus, 12(6). https://doi.org/10.7759/cureus.8562
MDCalc. (n. d.). MDCalc-Medical calculators, equations, scores, and guidelines. https://www.mdcalc.com/
Naderan, M., Shahr Babaki, A. E., Shoar, S., Mahmoodzadeh, H., Nasiri, S., & Khorgami, Z. (2016). Risk factors for the development of complicated appendicitis in adults. Turkish Journal of Surgery, 32(1), 37-42. https://doi.org/10.5152/UCD.2015.3031
Polat Düzgün, A., Pehlevan Özel, H., Şahingöz, E., & Dinç, T. (2024). Identification of complicated and non-complicated appendicitis: A new alvarado-based scoring system. Ulusal Travma ve Acil Cerrahi Dergisi = Turkish Journal of Trauma & Emergency Surgery: TJTES, 30(2), 101-106. https://doi.org/10.14744/tjtes.2024.70979
Rafael P, M., Quispe R, K., y Pantoja S, L. R. (2022). Apendicitis aguda: Concordancia clínica, quirúrgica y anatomopatológica en un hospital de emergencias peruano. Revista de la Facultad de Medicina Humana, 22(3), 463-470. https://doi.org/10.25176/rfmh.v22i3.4378
Schmidtke, R., & Orquendo Lorduy, A. (s.f.). The Humanitarian Effects of the COVID-19 Pandemic for Venezuelans in Peru, One Year In. Refugees International. https://www.refugeesinternational.org/reports-briefs/the-humanitarian-effects-of-the-covid-19-pandemic-for-venezuelans-in-peru-one-year-in/
Sezikli, İ., Topçu, R., & Bala, İ. M. (2024). Comparison of demographic and clinicopathological characteristics of refugees and Turkish citizens undergoing appendectomy. Journal of Comprehensive Surgery, 2(4), 76-79. https://doi.org/10.51271/JOCS-0041
Simmering, J. E., Polgreen, L. A., Talan, D. A., Cavanaugh, J. E., & Polgreen, P. M. (2022). Association of Appendicitis Incidence With Warmer Weather Independent of Season. JAMA Network Open, 5(10), e2234269. https://doi.org/10.1001/jamanetworkopen.2022.34269
Terlinder, J., & Andersson, R. E. (2016a). Incidence of appendicitis according to region of origin in first- and second-generation immigrants and adoptees in Sweden. A cohort follow-up study. Scandinavian Journal of Gastroenterology, 51(1), 111-120. https://doi.org/10.3109/00365521.2015.1030688
Virú-Flores, H. M., Roque-Quezada, J. C., Medina-Jimenez, A. N., Román-Yrigoín, M. J., Barturen-Julca, V. A., y Vega-Vega, R. R. (2025). Capacidad del Índice de Inflamación Sistémica Inmune (IISI) en el diagnóstico de la apendicitis aguda complicada en un hospital de referencia del Perú. Revista Colombiana de Cirugía. https://doi.org/10.30944/20117582.2847
Wickramasinghe, D. P., Xavier, C., & Samarasekera, D. N. (2021). The Worldwide Epidemiology of Acute Appendicitis: An Analysis of the Global Health Data Exchange Dataset. World Journal of Surgery, 45(7), 1999-2008. https://doi.org/10.1007/s00268-021-06077-5
Zavala-Curzo, D. (2023). Impacto del Aseguramiento en Salud en la Economía de los Hogares Peruanos, 2010-2019. Acta Médica Peruana, 40(2), 91-103. https://doi.org/10.35663/amp.2023.402.2527
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Delgado Montaño et al.

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Population and Health in Mesoamerica informs its authors and readers that all publications must be submitted with the Letter of Acceptance of Copyright Conditions where the authors are asked for authorization to submit the article to the Journal for consideration so that it may carry out any of the following activities:
- The graphic and style editing of the work or part of it.
The publication and reproduction of the work or part of it, both in print and electronic media, including the Internet and any other known or unknown technology.
The translation of the work or part of it into any language or dialect.
The adaptation of the work to reading, sound, voice and any other available technical representation or mechanism, which makes possible its access for partially or totally blind people, or with any other form of special abilities that prevent their access to the conventional reading of the article.
The distribution and availability of the work to the public, in such a way that the public may have access to them from the time and place that each person chooses, through the physical or electronic mechanisms available to them.
Any other form of use, process or system known or to be known that is related to the activities and editorial purposes to which the Journal is linked.
You can access the Letter by clicking HERE. If you have a question, please write to revista.ccp@ucr.ac.cr
In addition, the content of this site is protected under the Attribution - Noncommercial - Share Alike (by-nc-sa) license which permits commercial use of the original work or derivative works and distribution of which must be made under the same license that governs the original work. The graphic design, images and texts generated by the e-Information Science magazine are property of the Universidad de Costa Rica and are licensed under Creative Commons Attribution - NonCommercial - Attribution-ShareAlike 4.0 International.
Authors who publish in this journal accept the following conditions:
-The authors retain their moral rights over the publication and assign the patrimonial rights mentioned in the Letter of Assignment of Rights with the Creative Commons Attribution - NonCommercial - Compatitr Equal 4.0 International license, which allows third parties to use what is published as long as they mention the authorship of the work and to the first publication in this journal.
-Authors may make other independent and additional contractual arrangements for non-exclusive distribution of the version of the article published in this journal (e.g., inclusion in an institutional repository or publication in a book) as long as they clearly indicate that the work was first published in this journal.
This policy is established in accordance with Law 6638 on Copyright and Related Rights of the Republic of Costa Rica.