Delay Between Onset of Symptoms and Surgery in Acute Appendicitis Increases Perioperative Morbidity: A Prospective Study

World Journal of Surgery
Sten SaarU Lepner

Abstract

Despite significant progress in surgery, controversy persists about timing of appendectomy. Objective of this prospective observational study was to determine associations between time interval from onset of symptoms in appendicitis to appendectomy and postoperative complications. After institutional review board approval, all adult consecutive patients subjected to emergency appendectomy between 1/9/2013 and 1/12/2014 were prospectively enrolled. Data collection included demographics, open vs. laparoscopic appendectomy, comprehensive complication index (CCI), and 30-day follow-up. To determine time-dependent associations between delay of surgery and complications all patients were stratified into subgroups based on 12-h time intervals from onset of abdominal pain to surgery. Primary outcome was complications per CCI in correlation to delay from symptoms to appendectomy. Secondary outcomes included duration of surgery, hospital length of stay (HLOS), and incidence of complication within 30-day follow-up. A total of 266 patients with a mean age of 35.4 ± 14.8 years met inclusion criteria. Overall, 83.1 % of patients were subjected to laparoscopic appendectomy. Delay to surgery in 12-h increments showed stepwise-adjusted increase...Continue Reading

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Citations

Mar 5, 2016·World Journal of Surgery·Roland E Andersson
May 23, 2018·The Journal of Trauma and Acute Care Surgery·Sunil V PatelSusan B Brogly
Jul 8, 2018·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Jian LiXue-Lian Wu
May 18, 2017·ANZ Journal of Surgery·Hinetamatea MikaereAndrew D MacCormick
Dec 4, 2019·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Shaylan K GovindDennis Hong
Nov 2, 2020·The Journal of Surgical Research·Brittney M WilliamsAnthony Charles

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