Effect of delay to operation for adults with acute appendicitis

January 01, 0001

Effect of delay to operation for adults with acute appendicitis

These US authors examined the effect of delay from surgical admission to induction of anesthesia on outcomes after appendectomy for acute appendicitis in adults in a retrospective cohort study. Regression models yielded probabilities of outcomes adjusted for patient and operative risk factors.

They found: "Of 32,782 patients, 24,647 (75.2%) underwent operations within 6 hours of surgical admission, 4934 (15.1%) underwent operations more than 6 through 12 hours, and 3201 (9.8%) underwent operations more than 12 hours after surgical admission. Differences in operative duration (51, 50, and 55 minutes, respectively) were statistically significant but not clinically meaningful. The length of postoperative stay (2.2 days for the greater than 12- hour group vs 1.8 days for the remaining groups) was statistically significant but not clinically meaningful. No significant differences were found in adjusted overall morbidity (5.5%, 5.4%, and 6.1%, respectively) or serious morbidity/mortality (3.0%, 3.6%, and 3.0%, respectively). Duration from surgical admission to induction of anesthesia was not predictive in regression models for overall morbidity or serious morbidity/mortality."

The authors concluded: "In this retrospective study, delay of appendectomy for acute appendicitis in adults does not appear to adversely affect 30-day outcomes. This information can guide the use of potentially limited operative and professional resources allocated for emergency care."

It seems that surgeons are good judges of how quickly patients need surgery.


For the full abstract, click here.

Arch Surg 145(9):886-892, September 2010 © 2010 to the American Medical Association
Effect of Delay to Operation on Outcomes in Adults With Acute Appendicitis. Angela M. Ingraham, Mark E. Cohen, Karl Y. Bilimoria, et al. Correspondence to Dr. Ingraham: [email protected]

Category: HSR Health Services Research, D. Digestive. Keywords: acute appendicitis, appendectomy, outcomes, time to surgery, retrospective cohort study, journal watch.
Synopsis edited by Dr Linda French, Toledo, Ohio. Posted on Global Family Doctor 5 October 2010

Pearls are an independent product of the Cochrane primary care group and are meant for educational use and not to guide clinical care.

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