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Facilitating factors in same-day discharge after pediatric laparoscopic appendectomy
Olivia Cheng1, Linda Cheng2, Sathyaprasad Burjonrappa3
1Stony Brook University School of Medicine, Stony Brook, New York.
The Journal of Surgical Research
|June 26, 2018
Summary
Same-day discharge after pediatric laparoscopic appendectomy is safe and effective. This approach reduces hospital costs and infection risk without increasing complications or readmissions, enhancing patient satisfaction.
Area of Science:
- Pediatric Surgery
- Surgical Outcomes
- Healthcare Management
Background:
- Appendicitis is the most common surgical abdominal disorder in children.
- Enhanced Recovery After Surgery (ERAS) protocols aim to improve surgical patient recovery.
- ERAS pathways enhance care quality, shorten hospital stays, and improve recovery.
Purpose of the Study:
- To identify key factors enabling same-day discharge (SDD) after pediatric laparoscopic appendectomies.
- To assess early return to normal activities following SDD.
Main Methods:
- Retrospective chart review of pediatric patients (<18 years) undergoing appendectomy (Jan 2015-Apr 2017).
- Comparison of patients with SDD (discharge <24h) versus those with longer stays.
- Statistical analysis using Fisher's exact test and student t-test.
Main Results:
- 185 patients underwent laparoscopic appendectomy; 59.5% achieved SDD.
- SDD patients had significantly shorter time from surgical admission to operation (5.8 vs 11.4h).
- No significant difference in complication rates (0% vs 1.3%) or readmission rates (2.7% vs 2.7%) between groups. SDD significantly reduced hospital charges ($29,195 vs $33,703).
Conclusions:
- Surgical leadership can facilitate SDD in pediatric appendectomy safely.
- SDD reduces hospital costs and nosocomial infection risk.
- SDD enhances patient and family satisfaction without compromising safety.
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