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Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 9/2019

01-09-2019 | Original Article

CT Scan Findings Can Predict the Safety of Delayed Appendectomy for Acute Appendicitis

Authors: Byeong Geon Jeon, Hyuk Jung Kim, Seung Chul Heo

Published in: Journal of Gastrointestinal Surgery | Issue 9/2019

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Abstract

Background

The relationship between duration of in-hospital waiting time and outcomes from appendectomy in patients with suspected appendicitis remains equivocal. The aim of this study was to investigate the influence of in-hospital waiting time on perforation rates and clinical outcomes in patients with suspected appendicitis who underwent appendectomy.

Methods

A retrospective review of 5956 patients who underwent appendectomy at a single institution from January 2008 to December 2016 was performed. Patients were separated into two groups based on the duration from hospital arrival to surgery: patients with an in-hospital waiting time ≤ 12 h (no-delay group; n = 5287) and those with an in-hospital waiting time > 12 h (delayed group; n = 669). One-to-one propensity score matching (n = 421 per group) was performed to compare perforation rates and postoperative outcomes between the groups.

Results

After propensity score matching, an in-hospital waiting time > 12 h was not associated with increased rates of perforation and significant complications, such as wound infection and abscess. However, in the matched cohorts and in the patients whose initial CT scans suggested perforated appendicitis, the delayed group had a higher risk of developing postoperative ileus (OR 9.18, 95% CI 1.16–72.74, p = 0.021; OR 2.17, 95% CI 1.03–4.59, p = 0.048, respectively) and longer postoperative length of hospital stay (87.38 vs. 79.07 h, p = 0.008; 161.61 vs. 130.87 h, p < 0.001, respectively) than the no-delay group.

Conclusions

Our results indicate that a > 12-h in-hospital waiting time to surgery for appendicitis presents very little risk to the patient. However, the surgeon needs to carefully weigh the “safety” of a delay to surgery for appendicitis in patients whose initial CT scans suggested perforated appendicitis.
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Metadata
Title
CT Scan Findings Can Predict the Safety of Delayed Appendectomy for Acute Appendicitis
Authors
Byeong Geon Jeon
Hyuk Jung Kim
Seung Chul Heo
Publication date
01-09-2019
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 9/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-018-3911-x

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