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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
Summary
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.
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