Is a One Night Delay of Surgery Safe in Patients With Acute Appendicitis?

Abstract

Purpose: With varied reports on the impact of time to appendectomy on clinical outcomes, the purpose of this study was to determine the effect of preoperative in-hospital delay on the outcome for patients with acute appendicitis.

Methods: A retrospective review of 1,076 patients who had undergone an appendectomy between January 2010 and December 2013 was conducted.

Results: The outcomes of surgery and the pathologic findings were analyzed according to elapsed time. The overall elapsed time from onset of symptoms to surgery was positively associated with advanced pathology, increased number of complications, and prolonged hospital stay. In-hospital elapsed time was not associated with any advanced pathology (P = 0.52), increased number of postoperative complications (P = 0.14), or prolonged hospital stay (P = 0.24). However, the complication rate was increased when the in-hospital elapsed time exceeded 18 hours.

Conclusion: Advanced pathology and postoperative complication rate were associated with overall elapsed time from symptom onset to surgery rather than in-hospital elapse time. Therefore, a short-term delay of an appendectomy should be acceptable.

Keywords: Appendicitis; Delayed appendectomy.

Fig. 1. Receiver operating characteristic curve for the sensitivity vs. 1-specificity. The optimal cutoff point is marked as a white square box on the graph.