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Appendicitis-I: Introduction01:22

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Daytime versus Nighttime in Acute Appendicitis.

Wouter J Bom1,2, Joske de Jonge2, Jochem C G Scheijmans1

  • 1Department of Surgery, Amsterdam UMC, Location AMC, Amsterdam Gastroenterology & Metabolism, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands.

Diagnostics (Basel, Switzerland)
|April 23, 2022
PubMed
Summary
This summary is machine-generated.

Patients presenting with appendicitis at night face a higher risk of postoperative complications, even though complicated appendicitis occurs equally day and night. Nighttime presentation is an independent risk factor for complications.

Keywords:
complicated appendicitisdaynightuncomplicated appendicitis

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Area of Science:

  • General Surgery
  • Gastroenterology
  • Public Health

Background:

  • Appendicitis diagnosis and treatment are often assumed to be consistent regardless of time of day.
  • Limited research exists on the specific outcomes for patients presenting with appendicitis during nighttime hours.

Purpose of the Study:

  • To investigate whether nighttime presentation of appendicitis influences the rate of complicated appendicitis.
  • To determine if nighttime presentation is associated with an increased risk of postoperative complications compared to daytime presentation.

Main Methods:

  • Analysis of data from the prospective SNAPSHOT appendicitis study, including 1361 adult patients.
  • Comparison of complicated appendicitis rates and postoperative complication rates between daytime and nighttime presentations.
  • Multivariate analysis to adjust for baseline characteristics and time to surgery.

Main Results:

  • Complicated appendicitis rates were similar for both daytime and nighttime presentations (34%).
  • Postoperative complication rates were significantly higher for nighttime presentations (18.6%) versus daytime (12.1%).
  • Nighttime presentation was independently associated with an increased risk of postoperative complications (adjusted OR 1.74).

Conclusions:

  • The frequency of complicated appendicitis does not differ between day and nighttime presentations.
  • Patients presenting with acute appendicitis at nighttime have a significantly higher risk of postoperative complications.
  • Nighttime presentation, not early surgery, is an independent risk factor for postoperative complications in appendicitis.