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Related Concept Videos

Discharge Summary Forms01:31

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Esophageal Perforation-I: Introduction01:22

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Assessing safety in wind-exposed installations is crucial to preventing potential failures. This example explores the calculation and design adjustments needed to mount a circular disc on a building facade, where wind forces are a primary concern. A 4-meter diameter disc was initially designed as an aesthetic feature facing winds at a velocity of 25 meters per second, with an air density of 1.25 kilograms per cubic meter. Given these conditions, the drag force on the disc was determined using...
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Same-Day Discharge after Non-Perforated Laparoscopic Appendectomy Is Safe.

Areg Grigorian1, Catherine M Kuza2, Sebastian D Schubl1

  • 1Division of Trauma, Burns and Surgical Critical Care, Department of Surgery, University of California, Irvine, Orange, CA, USA.

Journal of Investigative Surgery : the Official Journal of the Academy of Surgical Research
|June 21, 2019
PubMed
Summary

Same-day discharge (SDD) for laparoscopic appendectomy (LA) in non-perforated appendicitis (NPA) is safe and effective. Nearly a quarter of patients are discharged the same day, with similar readmission risks and lower infection rates compared to longer stays.

Keywords:
ambulatoryappendectomyappendicitisoutpatientsame day surgerysurgical site infection

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Area of Science:

  • Surgical Outcomes
  • Health Services Research
  • Gastrointestinal Surgery

Background:

  • Single-center studies suggest same-day discharge (SDD) is safe for laparoscopic appendectomy (LA) in non-perforated appendicitis (NPA).
  • The national incidence of SDD for LA in NPA is not well-established.
  • Complication rates, including surgical site infections and readmissions, require further investigation for SDD patients.

Purpose of the Study:

  • To determine the national incidence of SDD among adult patients undergoing LA for NPA.
  • To compare complication rates (superficial surgical site infections, intra-abdominal abscess, 30-day readmission) between SDD and non-SDD patients.
  • To evaluate the safety and feasibility of SDD for LA in NPA.

Main Methods:

  • Utilized the 2016-2017 American College of Surgeons-National Surgical Quality Improvement Program (ACS-NSQIP) Procedure-Targeted Appendectomy database.
  • Included adult patients undergoing LA for non-perforated appendicitis without intraoperative perforation or abscess findings.
  • Employed multivariable logistic regression to compare outcomes between SDD and patients discharged within two days, adjusting for age and comorbidities.

Main Results:

  • Out of 16,931 patients, 3988 (23.6%) underwent SDD for LA after NPA.
  • SDD patients were similar in age but less likely to have a contaminated wound class compared to those with longer stays.
  • Adjusted analysis showed SDD was associated with similar 30-day readmission and abscess risks, but a significantly lower risk of superficial surgical site infections (SSSI).

Conclusions:

  • Approximately 23.6% of patients with NPA undergoing LA are discharged on the same day nationally.
  • SDD for NPA patients undergoing LA appears safe, demonstrating comparable readmission rates and a lower risk of SSSI.
  • The findings support the wider adoption of SDD for eligible NPA patients whenever feasible, considering potential selection bias and wound classification differences.