Same-day discharge for acute appendicectomy is safe: experience from a tertiary New Zealand hospital

Same-day discharge (SDD) following laparoscopic appendicectomy is internationally recognised as safe and effective, yet remains under-utilised in New Zealand. This study evaluates the safety and feasibility of SDD at Christchurch Hospital.

A retrospective review of adults undergoing laparoscopic appendicectomy for uncomplicated appendicitis between June 2015 and March 2024 was conducted using data from the SCOPE management system. Patients were divided into SDD (discharged before midnight) and delayed discharge (post-operative days 1-2) groups. The primary outcome was the complication rate (Clavien-Dindo grade ≥3); the secondary outcome was 30-day readmission.

Of 2,258 patients, 213 (9.4%) were discharged the same day and 2,045 (90.6%) after at least 1 night. Baseline demographics were similar except for age (32.2 vs 29.9 years, p=0.008) and sex (female 55.1% vs 37.6%, p<0.001). There were no significant differences in complication (0% vs 0.6%, p=0.626) or readmission rates (7.0% vs 6.7%, p=0.775). Morning operations were significantly more likely to result in SDD (74.6% vs 26.3%, p<0.0001).

SDD after laparoscopic appendicectomy for uncomplicated appendicitis is safe and effective without increasing complications or readmissions. Implementing structured SDD protocols could enhance hospital efficiency and reduce costs.