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Same-Day Discharge Following Laparoscopic Appendectomy for Uncomplicated Acute Appendicitis as a Measure of Quality

Jeffrey M Halter1,2, Baird Mallory1,2, Ian R Neilson1,2

  • 11 Department of Surgery, Maine Medical Center , Portland, Maine.

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
|April 9, 2016
PubMed

Insights

Same-day discharge (SD) after laparoscopic appendectomy (LA) for uncomplicated appendicitis in children is safe and effective. This approach reduces length of stay and costs without increasing complications, while maintaining high patient satisfaction.

Area of Science:

  • Pediatric Surgery
  • Surgical Outcomes
  • Healthcare Economics

Background:

  • Acute appendicitis is the most common surgical emergency in children.
  • Laparactic appendectomy (LA) is the standard treatment.
  • Same-day discharge (SD) after LA for uncomplicated appendicitis is feasible and safe.

Purpose of the Study:

  • To determine if SD following LA for uncomplicated appendicitis in children improves quality of care.
  • To compare SD with next-day discharge (ND) regarding cost, patient satisfaction, and complications.

Main Methods:

  • Retrospective review of 236 children (1-18 years) treated with LA for uncomplicated appendicitis.
  • Comparison of SD (n=121) versus ND (n=115) groups.
  • Analysis of baseline characteristics, complications, length of stay (LOS), and hospital charges.

Main Results:

  • SD was associated with significantly shorter LOS (11.8 vs. 24.8 hours) and lower costs ($10,551 vs. $12,691).
  • Postoperative complications were similar between SD and ND groups.
  • 80% of surveyed families opted for future SD.

Conclusions:

  • SD following LA for uncomplicated appendicitis in children offers significant cost and LOS savings.
  • SD does not increase complications and maintains good patient/family satisfaction.
  • SD could become the standard of care, enhancing quality and value.
Abstract

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