Laparoscopic appendectomy is safer than open appendectomy in an elderly population

Area of Science:

• Surgical Outcomes Research
• Geriatric Surgery
• Minimally Invasive Surgery

Background:

• Evaluating perioperative patient safety outcomes for laparoscopic appendectomy versus open appendectomy in the elderly (age ≥65).
• Assessing outcomes during the widespread adoption of laparoscopic appendectomy.

Purpose of the Study:

• To compare patient safety outcomes between laparoscopic and open appendectomy in elderly patients.
• To determine if the increasing use of laparoscopic appendectomy impacts safety in this demographic.

Main Methods:

• Cross-sectional analysis of the US Nationwide Inpatient Sample (1998-2009).
• Used weighted sampling to estimate national trends.
• Multivariate logistic regression to analyze the association of laparoscopy with perioperative outcomes.

Main Results:

• Laparoscopic appendectomy was associated with a decreased length of stay (4.44 vs 7.86 days).
• Fewer patient safety indicator events occurred with laparoscopic appendectomy (1.8% vs 3.5%).
• Mortality rates were lower for laparoscopic appendectomy (0.9% vs 2.8%).

Conclusions:

• Laparoscopic appendectomy demonstrates improved clinical outcomes in the elderly population.
• The diffusion of laparoscopic appendectomy has not been linked to adverse patient safety events in this age group.