The impact of operative timing on outcomes of appendicitis: a National Surgical Quality Improvement Project analysis.

Autor: Fair BA; Department of General Surgery, Professional Building, Suite 810, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL 60612, USA., Kubasiak JC; Department of General Surgery, Professional Building, Suite 810, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL 60612, USA., Janssen I; Department of Preventative Medicine, Triangle Office Building, Suite 470, Rush Graduate College, 1700 W. Van Buren Street, Chicago, IL 60612, USA., Myers JA; Department of General Surgery, Professional Building, Suite 810, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL 60612, USA., Millikan KW; Department of General Surgery, Professional Building, Suite 810, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL 60612, USA., Deziel DJ; Department of General Surgery, Professional Building, Suite 810, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL 60612, USA., Luu MB; Department of General Surgery, Professional Building, Suite 810, Rush University Medical Center, 1725 West Harrison Street, Chicago, IL 60612, USA. Electronic address: Minh_B_Luu@rush.edu.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2015 Mar; Vol. 209 (3), pp. 498-502. Date of Electronic Publication: 2014 Dec 13.
DOI: 10.1016/j.amjsurg.2014.10.013
Abstrakt: Background: Surgery is indicated for acute uncomplicated appendicitis but the optimal timing is controversial. Recent literature is conflicting on the effect of time to intervention.
Methods: We queried the American College of Surgeons National Surgical Quality Improvement Project dataset for patients undergoing laparoscopic and open appendectomy between 2007 and 2012. Logistic regression was used to evaluate 30-day morbidity and mortality of intervention at different time periods, adjusting for preoperative risk factors.
Results: A total of 69,926 patients undergoing appendectomy were identified. Groups were divided by time to intervention: group 1, less than 24 hours (n = 55,839; 79.9%); group 2, 24 to 48 hours (n = 13,409; 18.6%); and group 3, greater than 48 hours (n = 1,038; 1.5%). After adjustment, the risk of complication remained increased for group 3 versus group 1 or 2 (odds ratio 1.66, 95% confidence interval 1.34 to 2.07).
Conclusions: These data demonstrate equivalent outcomes between time to appendectomy of less than 24 and 24 to 48 hours. There was a 2-fold increase in complication rate for patients delayed longer than 48 hours.
(Copyright © 2015 Elsevier Inc. All rights reserved.)
Databáze: MEDLINE
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