Related Experiment Video

Updated: Apr 27, 2026

Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis
03:42

Author Spotlight: Advancements in Retroperitoneal Approach for Necrotizing Pancreatitis

Published on: March 15, 2024

1.6K

Impact of a 24-hour discharge pathway on outcomes of pediatric appendectomy

Luke R Putnam1, Shauna M Levy1, Elizabeth Johnson2

  • 1Center for Surgical Trials and Evidence-based Practice, University of Texas Medical School at Houston, Houston, TX; Department of Pediatric Surgery, University of Texas Medical School at Houston, Houston, TX; Children's Memorial Hermann Hospital, Houston, TX.

Surgery
|June 26, 2014
PubMed

Insights

Implementing a same-day discharge (SDD) pathway for simple appendicitis in children significantly reduced hospital length of stay (LOS). While effective, the pathway led to a slight increase in readmissions, requiring further study.

Area of Science:

  • Pediatric Surgery
  • Clinical Pathways
  • Healthcare Management

Background:

  • Standardized clinical pathways can potentially reduce hospital length of stay (LOS) for simple appendicitis.
  • A same-day discharge (SDD) pathway was implemented for pediatric simple appendicitis to evaluate its effectiveness.

Purpose of the Study:

  • To assess the impact of a standardized SDD pathway on pediatric simple appendicitis care.
  • To evaluate changes in hospital LOS, surgical-site infections, and readmissions post-pathway implementation.

Main Methods:

  • A prospective cohort of pediatric patients (<18 years) undergoing appendectomy for simple appendicitis was compared to a historic cohort.
  • Primary outcomes included LOS, surgical-site infections, and readmissions.
  • Statistical analyses included Mann Whitney U test, Fischer exact test, χ(2) test, and logistic regression.

Main Results:

  • Hospital LOS decreased by 37% after pathway implementation (median 35 to 22 hours, P < .001).
  • Same-day discharge (SDD) rates increased significantly from 13% to 58% (P < .001).
  • Infectious complications remained unchanged (1.6% vs 1.8%), but readmissions increased (1.2% vs 4.2%, P = .02).

Conclusions:

  • A standardized pathway targeting SDD for pediatric simple appendicitis is achievable.
  • The pathway effectively reduced LOS and increased SDD rates.
  • Further investigation is needed to determine readmission risks, cost-effectiveness, and generalizability.
Abstract

More Related Videos

Reverse Needle Continuous Suture of the Pancreatic Duct to Jejunal Mucosal Pancreaticointestinal Anastomosis in Laparoscopic Pancreaticoduodenectomy04:31

Reverse Needle Continuous Suture of the Pancreatic Duct to Jejunal Mucosal Pancreaticointestinal Anastomosis in Laparoscopic Pancreaticoduodenectomy

Published on: August 29, 2025

735

Related Concept Videos

Appendicitis-II: Diagnostic Studies and Management01:29

Appendicitis-II: Diagnostic Studies and Management

Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
930
Appendicitis01:19

Appendicitis

Appendicitis is an acute inflammatory condition of the vermiform appendix, most commonly caused by obstruction of its lumen. The appendix is a narrow, blind-ended pouch that extends from the cecum, making it particularly prone to obstruction. Causes include fecaliths, lymphoid hyperplasia (often after viral infections), parasites, tumors, or foreign bodies. This obstruction initiates a cascade of pathological changes.Luminal Obstruction and Early InflammationAfter obstruction, normal mucosal...
28
Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications01:25

Peritoneal Dialysis II: Peritoneal Dialysis Systems and Complications

Peritoneal dialysis (PD) is a medical process that removes waste products and excess fluid from the body using the peritoneal membrane as a natural filter.Peritoneal Dialysis MethodsSeveral methods can be used for peritoneal dialysis, including Acute Intermittent Peritoneal Dialysis, Continuous Ambulatory Peritoneal Dialysis, and Automated Peritoneal Dialysis, also known as Continuous Cyclic Peritoneal Dialysis.Acute Intermittent Peritoneal Dialysis (AIPD) is used for patients with uremic...
2.1K
Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
4.4K
Peripheral Artery Disease V: Postoperative Nursing Management01:23

Peripheral Artery Disease V: Postoperative Nursing Management

During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...
629