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Same-Day Discharge for Nonperforated Appendicitis in Children: An Updated Institutional Protocol

Leo Andrew Benedict1, Joseph Sujka1, Justin Sobrino1

  • 1Department of Surgery, Children's Mercy Hospital, Kansas City, Missouri.

The Journal of Surgical Research
|November 23, 2018
PubMed

Insights

Same-day discharge (SDD) after laparoscopic appendectomy is effective for children with nonperforated appendicitis. This approach significantly reduces hospital stay duration without increasing readmission rates, enhancing healthcare efficiency.

Area of Science:

  • Pediatric Surgery
  • Surgical Outcomes
  • Healthcare Efficiency

Background:

  • Healthcare systems face pressure to increase efficiency and safety while reducing hospital stays.
  • Same-day discharge (SDD) protocols are being implemented for laparoscopic appendectomy.
  • Previous studies showed a 28% SDD rate in children with nonperforated appendicitis.

Purpose of the Study:

  • To evaluate the effectiveness of a mature SDD protocol for pediatric laparoscopic appendectomy.
  • Assess discharge success, duration of hospital stay, and readmission rates.
  • Determine if SDD impacts patient safety and resource utilization.

Main Methods:

  • Retrospective review of prospectively collected data from December 2015 to July 2017.
  • Inclusion criteria: Children undergoing laparoscopic appendectomy for nonperforated appendicitis.
  • Comparative analysis of same-day discharge versus overnight stay groups.

Main Results:

  • 87% of 569 children were discharged the same day (median stay: 4 hours vs. 19 hours for overnight stays).
  • Procedures after 6 PM were associated with higher overnight stays.
  • Same-day discharge had similar readmission rates (2%) compared to overnight stays (4%).

Conclusions:

  • Same-day discharge after pediatric laparoscopic appendectomy for nonperforated appendicitis is safe and effective.
  • SDD significantly reduces postoperative length of hospital stay.
  • SDD does not lead to increased hospital readmission rates, supporting its wider adoption.
Abstract

Keywords:
Health care resource utilizationNonperforated appendicitisSame day discharge

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