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CT Scan Findings Can Predict the Safety of Delayed Appendectomy for Acute Appendicitis
Byeong Geon Jeon1, Hyuk Jung Kim2, Seung Chul Heo3,4
1Department of Surgery, Daejin Medical Center Bundang Jesaeng General Hospital, Sungnam-si, Republic of Korea.
Summary
A waiting time over 12 hours for appendectomy surgery did not increase perforation rates. However, delays may increase the risk of postoperative ileus and longer hospital stays, especially if appendicitis is suspected to be perforated.
Area of Science:
- Surgery
- Gastroenterology
- Clinical Outcomes Research
Background:
- The impact of in-hospital waiting times on appendectomy outcomes is unclear.
- This study investigated the association between waiting time and perforation rates or clinical outcomes in appendicitis patients.
Purpose of the Study:
- To determine if in-hospital waiting times exceeding 12 hours for appendectomy affect perforation rates.
- To assess the influence of waiting time on postoperative complications and length of stay.
Main Methods:
- Retrospective review of 5956 appendectomy patients (January 2008-December 2016).
- Patients grouped by in-hospital waiting time: ≤12 hours (no-delay) vs. >12 hours (delayed).
- One-to-one propensity score matching (421 patients per group) for outcome comparison.
Main Results:
- Waiting times >12 hours were not linked to increased perforation or major complications (wound infection, abscess).
- Delayed group showed higher risk of postoperative ileus (OR 9.18, p=0.021; OR 2.17, p=0.048).
- Delayed group experienced longer postoperative hospital stays (87.38 vs. 79.07 h, p=0.008; 161.61 vs. 130.87 h, p<0.001).
Conclusions:
- In-hospital waiting times >12 hours for appendectomy pose minimal risk regarding perforation.
- Surgeons should cautiously consider delays for patients with CT-indicated perforated appendicitis.
- Potential for increased postoperative ileus and extended hospital stay with delayed surgery warrants consideration.
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