Same-day discharge after appendectomy for acute appendicitis: a systematic review and meta-analysis

Area of Science:

• Surgical outcomes and patient management.

Background:

• Appendectomy for acute appendicitis typically involves several days of hospitalization.
• Reducing hospital stay can enhance patient satisfaction and decrease healthcare costs.

Purpose of the Study:

• To evaluate the safety and efficacy of same-day discharge following appendectomy for acute appendicitis.

Main Methods:

• A systematic review and meta-analysis adhering to PRISMA guidelines.
• Literature search across major databases (EMBASE, MEDLINE, Web of Science, Cochrane, Google Scholar) up to April 2020.
• Analysis of comparative and non-comparative studies focusing on same-day discharge outcomes, including readmission, complications, and unplanned visits.

Main Results:

• Meta-analysis of 17 comparative studies and 8 non-comparative studies revealed no increased risk of readmission, complications, or unplanned hospital visits with same-day discharge compared to overnight hospitalization.
• Most included studies focused on laparoscopic procedures for uncomplicated appendicitis.
• Non-comparative studies also indicated low rates of adverse events after same-day discharge.

Conclusions:

• Same-day discharge after laparoscopic appendectomy for uncomplicated appendicitis is a safe strategy.
• This approach does not elevate the risk of readmission, complications, or unplanned hospital visits.
• Consideration for same-day discharge in carefully selected patients is warranted to potentially improve efficiency and satisfaction.