Appendicectomy deferred to a CEPOD list: the patients' opinion

Area of Science:

• Surgery
• Patient Care
• Healthcare Policy

Background:

• National Confidential Enquiry into Perioperative Deaths (NCEPOD) guidelines and European Working Time Directive (EWTD) have reshaped surgical practices.
• Emergency surgical admissions outside standard hours are frequently deferred to the next day, impacting patient management.

Purpose of the Study:

• To evaluate patient opinions on the deferral of emergency surgical procedures to the next day.
• To assess patient satisfaction with management plans involving delayed operations.

Main Methods:

• A study of 42 consecutive patients admitted with uncomplicated appendicitis whose operations were deferred.
• Patients received explanations for deferral and were informed about a different surgeon performing the procedure.
• Post-operative questionnaires were administered to gather patient feedback.

Main Results:

• Most patients (24/42) preferred same-night surgery, with poor sleep reported by those whose operations were delayed.
• A significant number of patients (22/42) preferred the admitting surgeon to operate.
• Patient recall of explanations for deferral was low, and many were unaware of who performed their surgery.

Conclusions:

• Despite explanations, most patients prefer immediate surgery over delayed procedures.
• Pre-operative sleep disturbance is a key factor influencing patient dissatisfaction.
• Patient preference leans towards the admitting surgeon, with minimal desire for a new surgeon the following day.