Ann Surg Treat Res.  2016 Aug;91(2):85-89. 10.4174/astr.2016.91.2.85.

Effect of surgical timing and outcomes for appendicitis severity

Affiliations
  • 1Department of Trauma Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. surgeryman@catholic.ac.kr

Abstract

PURPOSE
This study was aimed to evaluate the effect of time of surgery for acute appendicitis on surgical outcomes to optimize the timing of appendectomies.
METHODS
Medical records of patients who underwent an appendectomy were reviewed to obtain data on time of symptom onset, time of hospital presentation, and start times of surgery. Surgical findings were used to define appendicitis as either uncomplicated or complicated. The uncomplicated group included patients with simple, focal, or suppurative appendicitis, and the complicated group included patients with gangrenous, perforated appendicitis or periappendiceal abscess formation. The 2 groups were analyzed by age, sex, and time.
RESULTS
A total of 192 patients were analyzed. The mean time from symptom onset to start of operation showed a significant difference between both groups (1,652.9 minutes vs. 3,383.8 minutes, P < 0.001). The mean time from hospital visit to start of operation showed no difference between both groups (398.7 minutes vs. 402.0 minutes, P = 0.895). Operating within 24 hours of symptom onset had a relative risk of 1.738 (95% confidence interval, 1.319-2.425) for complications. Operating more than 36 hours after symptom onset was associated with an increased risk of postoperative ileus and a longer hospital stay.
CONCLUSION
Complicated appendicitis is associated with a delay in surgery from symptom onset rather than a delay at hospital arrival. Surgeons should take into account the time from symptom onset when deciding on the timing of appendectomy. We recommend that appendectomy be performed within 36 hours from symptom onset.

Keyword

Appendectomy; Appendicitis; Treatment outcome

MeSH Terms

Abscess
Appendectomy
Appendicitis*
Humans
Ileus
Length of Stay
Medical Records
Surgeons
Treatment Outcome

Cited by  2 articles

Early versus late surgical management for complicated appendicitis in adults: a multicenter propensity score matching study
Jeong Yeon Kim, Jong Wan Kim, Jun Ho Park, Byung Chun Kim, Sang Nam Yoon
Ann Surg Treat Res. 2019;97(2):103-111.    doi: 10.4174/astr.2019.97.2.103.

Impact of COVID-19 on the care of acute appendicitis: a single-center experience in Korea
Chang Woo Kim, Suk-Hwan Lee
Ann Surg Treat Res. 2021;101(4):240-246.    doi: 10.4174/astr.2021.101.4.240.


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