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

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.