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Criteria-led discharge for simple appendicitis in children: A pilot study

Bridget Roddis1, Nicholas Ensor1, Shona Williamson2

  • 1Department of Paediatric Surgery and Surgical Simulation, Monash Children's Hospital, Melbourne, Victoria, Australia.

Journal of Paediatrics and Child Health
|April 9, 2022
PubMed

Insights

Criteria-led discharge (CLD) is a safe and feasible approach for pediatric simple appendicitis. While it did not reduce hospital stay, parents reported high satisfaction with this discharge method.

Area of Science:

  • Pediatric Surgery
  • Healthcare Management
  • Patient Discharge

Background:

  • Criteria-led discharge (CLD) protocols aim to improve hospital discharge efficiency post-surgery.
  • Evaluating CLD for pediatric simple appendicitis (SA) is crucial for optimizing care pathways.

Purpose of the Study:

  • To assess the feasibility, clinical outcomes, and parental satisfaction of a pilot CLD protocol for pediatric SA.
  • To compare CLD with standard discharge procedures in terms of post-operative length of stay (pLOS) and complication rates.

Main Methods:

  • A prospective pilot cohort study comparing CLD (35 patients) with standard discharge (31 patients) for pediatric SA.
  • Utilized a CLD pro forma with standardized care guidelines and clinical discharge criteria.
  • Assessed pLOS, post-operative complications, and parental satisfaction via a post-discharge survey.

Main Results:

  • No significant difference in median pLOS between the CLD (25.3 h) and control (24 h) groups (P=0.3).
  • No significant differences observed in secondary outcomes, including post-operative complication rates.
  • Parental confidence in discharge was high in both groups (CLD: 88.2%, Control: 85.7%).

Conclusions:

  • The implementation of CLD for pediatric SA is safe and feasible.
  • This pilot study did not demonstrate a reduction in pLOS but indicated strong parental acceptance.
  • CLD shows promise as a well-accepted discharge strategy in pediatric surgery.
Abstract

Keywords:
appendicitiscriteria led dischargeevent led dischargepaediatric surgery

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