Population-level outcomes of early versus delayed appendectomy for acute appendicitis using the American College of Surgeons National Surgical Quality Improvement Program

Alore, Elizabeth A.; Ward, Jeremy L.; Todd, S. Rob; Wilson, Chad T.; Gordy, Stephanie; Hoffman, Marcus; Suliburk, James W.

doi:10.1016/j.jss.2018.04.011

Cited by 35 publications

(29 citation statements)

References 15 publications

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“…Seudeal et al also found similar results in their study proving that a delay in surgery for uncomplicated appendicitis does not increase the risk of perioperative complication rate, length of hospital stay, rate of readmission or mortality. 6 These results are also supported by works of Alore E et al 1…”

Section: Work Done In Turkey By Avci V Et Al Suggests Thatsupporting

confidence: 73%

“…4 The rates of complications is calculated to be around 10% in most of the studies 6 and not more than 14% even when surgery is delayed for up to 72 hours. 1 Many studies now suggest that pre-hospital delay is more significant and once the patient is admitted, delay less than 24 hours does not significantly increase the risk of perforation. 2 Open and laparoscopic procedures have both been widely practiced and compared, with laparoscopic surgery proving to produce more favorable results.…”

Section: Work Done In Turkey By Avci V Et Al Suggests Thatmentioning

confidence: 99%

“…Appendectomy is one of the most common surgical procedures done worldwide. 1 Laparoscopic and open approach both can be used to perform this surgery with some studies favoring the laparoscopic approach as it is associated with less complications. 1 The optimal timing of appendectomy has traditionally been considered to be within the first few hours of admission.…”

Section: Introductionmentioning

confidence: 99%

“…1 Laparoscopic and open approach both can be used to perform this surgery with some studies favoring the laparoscopic approach as it is associated with less complications. 1 The optimal timing of appendectomy has traditionally been considered to be within the first few hours of admission. 2 Perforation, generalized peritonitis, portal pyemia are some of the life threatening complications associated with acute appendicitis (AA).…”

Section: Introductionmentioning

confidence: 99%

“…In addition to these, surgical site infections, mass formation and iatrogenic trauma to surrounding structures during adhesionolysis are also common. 1,3 These complications become more pronounced in extremes of ages. 4 In recent years the trends in management of AA are shifting towards a more conservative approach.…”

Section: Introductionmentioning

confidence: 99%

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Early versus delayed appendectomy for uncomplicated acute appendicitis.

Javed¹,

Saleem²,

Rehman³

et al. 2020

TPMJ

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Study Design: Sectional study. Setting: Madina Teaching Hospital Faisalabad. Period: July 2018 to June 2019. Material & Methods: A sample of 107 patients was selected using non-probability purposive sampling out of all the patients presenting with acute appendicitis. Study population was divided into Groups A and B, former undergoing appendectomy within 8 hours of admission and later undergoing surgery more than 8 hours after admission. Spinal and general anesthesia was used and both Laparoscopic and open surgical techniques were employed. Results: Out of total 107 patients, 62 (57.94%)were placed in group A and 45 (42.06%) in group B. Age and gender related distribution in both groups were similar. 5 patients in group A had perforated appendix and 3 patients in Group B were found to have perforated appendix. The difference between incidence of perforation between the two groups was not statistically significant. Conclusion: in-hospital delay before appendectomy does not significantly increase the risk of perforation in uncomplicated acute appendicitis.

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Section: Work Done In Turkey By Avci V Et Al Suggests Thatsupporting

confidence: 73%

Section: Work Done In Turkey By Avci V Et Al Suggests Thatmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Early versus delayed appendectomy for uncomplicated acute appendicitis.

Javed¹,

Saleem²,

Rehman³

et al. 2020

TPMJ

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Factors Associated With Potentially Missed Diagnosis of Appendicitis in the Emergency Department

et al. 2020

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IMPORTANCE Appendicitis may be missed during initial emergency department (ED) presentation.OBJECTIVE To compare patients with a potentially missed diagnosis of appendicitis (ie, patients with symptoms associated with appendicitis, including abdominal pain, constipation, nausea and/or vomiting, fever, and diarrhea diagnosed within 1-30 days after initial ED presentation) with patients diagnosed with appendicitis on the same day of ED presentation to identify factors associated with potentially missed appendicitis. DESIGN, SETTING, AND PARTICIPANTSIn this cohort study, a retrospective analysis of commercially insured claims data was conducted from January 1 to December 15, 2019. Patients who presented to the ED with undifferentiated symptoms associated with appendicitis between January 1, 2010, and December 31, 2017, were identified using the Clinformatics Data Mart administrative database (Optum Insights). The study sample comprised eligible adults (aged Ն18 years) and children (aged <18 years) who had previous ED visits within 30 days of an appendicitis diagnosis. MAIN OUTCOMES AND MEASURESPotentially missed diagnosis of appendicitis. Adjusted odds ratios (AORs) for abdominal pain and its combinations with other symptoms associated with appendicitis were compared between patients with a same-day diagnosis of appendicitis and patients with a potentially missed diagnosis of appendicitis. RESULTSOf 187 461 patients with a diagnosis of appendicitis, a total of 123 711 (66%; 101 375 adults [81.9%] and 22 336 children [18.1%]) were eligible for analysis. Among adults, 51 923 (51.2%) were women, with a mean (SD) age of 44.3 (18.2) years; among children, 9631 (43.1%) were girls, with a mean (SD) age of 12.2 (18.2) years. The frequency of potentially missed appendicitis was 6060 of 101 375 adults (6.0%) and 973 of 22 336 children (4.4%). Patients with isolated abdominal pain (adults, AOR, 0.65; 95% CI, 0.62-0.69; P < .001; children, AOR, 0.79; 95% CI, 0.69-0.90; P < .001) or with abdominal pain and nausea and/or vomiting (adults, AOR, 0.90; 95% CI, 0.84-0.97; P = .003; children, AOR, 0.84; 95% CI, 0.71-0.98; P = .03) were less likely to have missed appendicitis. Patients with abdominal pain and constipation (adults, AOR, 1.51; 95% CI, 1.31-1.75; P < .001; children, AOR, 2.43; 95% CI, 1.86-3.17; P < .001) were more likely to have missed appendicitis. Stratified by the presence of undifferentiated symptoms, women (abdominal pain, AOR, 1.68; 95% CI, 1.58-1.78; nausea and/or vomiting, AOR, 1.68; 95% CI, 1.52-1.85; fever, AOR, 1.32; 95% CI, 1.10-1.59; diarrhea, AOR, 1.19; 95% CI, 1.01-1.40; and constipation, AOR, 1.50; 95% CI, 1.24-1.82) and girls (abdominal pain, AOR, 1.64; 95% CI, 1.43-1.88; nausea and/or vomiting, AOR, 1.74; 95% CI, 1.42-2.13; fever, AOR, 1.55; 95% CI, 1.14-2.11; diarrhea, AOR, 1.80; 95% CI, 1.19-2.74; and constipation, AOR, 1.25; 95% CI, 0.88-1.78) as well as patients with a comorbidity index of 2 or greater (adults, abdominal pain, AOR, 3.33; 95% CI, 3.09-3.60; nausea and/or vomiting, AOR, 3.66; 95% CI, ...

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Risk of emergency surgery for complicated appendicitis: Japanese nationwide study

Yamada

Endo

Hasegawa

et al. 2020

Annals of Gastroent Surgery

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Aim Appendicitis is divided into two categories: complicated appendicitis (CA) and uncomplicated appendicitis (UA). In pediatric patients with CA, the use of interval appendectomy (IA), which is non‐operative management followed by elective surgery, has decreased the number of postoperative complications. Before discussing the merit of IA for adult patients, we need to clarify whether the frequency and seriousness of the complication rate after emergency surgery is higher for CA than for UA. Methods This retrospective cohort study included adult patients who underwent appendectomy and who were registered in the National Clinical Database (NCD) from 2014 to 2016. Patients with CA who underwent emergency appendectomy comprised the CA group. Patients with UA comprised the UA group. Patients with chronic or recurrent appendicitis who underwent elective appendectomy comprised the elective appendectomy (EA) group. Primary outcomes were all morbidity, serious morbidity, and mortality within 30 days after appendectomy. Results We included 109 256 patients in the study: 14 798 CA, 86 876 UA, and 7582 EA patients. Compared with the UA group, the rates of all morbidity, serious morbidity, and mortality were significantly higher in the CA group. All morbidity, serious morbidity, and mortality rates were significantly lower in the EA group than in the other two groups. Conclusions We confirmed that emergency surgery for CA places the patient at relatively higher risk. We also showed that the risk associated with EA is significantly lower than that for the other methods.

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Population-level outcomes of early versus delayed appendectomy for acute appendicitis using the American College of Surgeons National Surgical Quality Improvement Program

Cited by 35 publications

References 15 publications

Early versus delayed appendectomy for uncomplicated acute appendicitis.

Early versus delayed appendectomy for uncomplicated acute appendicitis.

Factors Associated With Potentially Missed Diagnosis of Appendicitis in the Emergency Department

Risk of emergency surgery for complicated appendicitis: Japanese nationwide study

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