Aims: Both patient and hospital-related factors determine the timing of appendicectomy for acute uncomplicated appendicitis. Recent literature suggests appendicectomy more than 24 h after hospital admission is associated with increased morbidity in adults. Current guidelines from the World Society of Emergency Surgery (WSES) recommend surgery within this timeframe to reduce the risk of complications. The aim of this study was to determine the time to surgery for patients with acute uncomplicated appendicitis and to compare this to the current WSES recommendations. This study also aimed to identify potential reasons for any in-hospital delay.
Methods: This study is a retrospective review of all patients who underwent appendicectomy for confirmed acute uncomplicated appendicitis at an adult university teaching hospital between September 2021 and September 2022. Patient demographics, clinical information, time of admission, time of surgery, time of discharge and surgical complication data were collected.
Results: A total of 229 appendicectomies were performed during the study period. 138 (60 %) had a preoperative diagnosis of acute uncomplicated appendicitis. The median age was 36 years (range 17-93). Time to surgery was <24 h in 80 (58 %) patients and >24 h in 58 (42 %) patients. In patients with a delay of >24 h, 28 (48 %) had their surgery 24-36 h after admission, 23 (40 %) had their surgery between 36 and 48 h, and 7 (12 %) had their surgery >48 h after admission. Patients who were operated >24 h after admission had a higher rate of readmission, 4/58 (6.9 %) compared to 1/80 (1.25 %) in the less than 24 h group (p = 0.09). Delays in radiology, surgical ward beds and the lack of a dedicated emergency theatre may have contributed to extended waiting times.
Conclusion: The results of this study show that the majority (58 %) of patients within our cohort were operated on within the WSES guidelines. However, 42 % of patients had their surgery in excess of these recommendations. Extended waiting periods may be related to delays in radiology, surgical ward beds and a lack of a dedicated emergency theatre. Patients who were operated on greater than 24 h following their admission also had a higher rate of readmission.
Download full-text PDF |
Source |
---|---|
http://dx.doi.org/10.1016/j.surge.2024.11.011 | DOI Listing |
Arch Gynecol Obstet
December 2024
Laboratory of Healthcare Research and Pharmacoepidemiology, Division of Biostatistics, Epidemiology and Public Health, Department of Statistics and Quantitative Methods, University of Milano-Bicocca, Via Bicocca degli Arcimboldi, 8 (Building U7), 20126, Milan, Italy.
Purpose: Acute appendicitis during pregnancy poses unique challenges due to altered anatomical and physiological dynamics and concern about foetal well-being. This study aimed to assess management strategies and outcomes of acute appendicitis during pregnancy, focusing on non-operative management versus surgical intervention.
Methods: The study is based on the computerized healthcare utilization database of Lombardy.
Radiol Case Rep
February 2025
Department of Radiology, Chitwan Medical College, Chitwan, Nepal.
Internal hernias, including Left para duodenal Hernias (LPDH), are rare and challenging to diagnose due to their nonspecific symptoms and complex anatomical presentation. This report presents a unique case of a 29-year-old female with preoperatively diagnosed uncomplicated LPDH, complicated by distal bowel ischemia-a manifestation not extensively documented in existing literature. Initial imaging revealed dilated jejunal loops indicative of LPDH, with subsequent contrast-enhanced computed tomography (CECT) showing ischemic changes in bowel segments distal to the hernia.
View Article and Find Full Text PDFCureus
November 2024
Cardiothoracic Surgery, Albany Medical Center, Albany, USA.
A 27-year-old female with a history of acute lymphoblastic leukemia in remission presented with chest pain, liver cirrhosis, and a thrombus in the hepatic vein on ultrasound. Further workup with computed tomography (CT) and magnetic resonance imaging (MRI) revealed a mass extending from the inferior vena cava to the right atrium, 3.4 x 3.
View Article and Find Full Text PDFSurgeon
December 2024
Department of Breast, Endocrine and General Surgery, St. Vincent's University Hospital, Elm Park, Dublin, Ireland. Electronic address:
Aims: Both patient and hospital-related factors determine the timing of appendicectomy for acute uncomplicated appendicitis. Recent literature suggests appendicectomy more than 24 h after hospital admission is associated with increased morbidity in adults. Current guidelines from the World Society of Emergency Surgery (WSES) recommend surgery within this timeframe to reduce the risk of complications.
View Article and Find Full Text PDFEur J Cardiothorac Surg
December 2024
Department of Vascular Surgery, Inselspital, Bern University Hospital, University of Bern, Switzerland.
Objectives: This study aimed to assess survival rates and the causes of both early and late mortality in patients with Stanford type B aortic dissection (TBAAD).
Methods: A retrospective analysis was conducted on all consecutive patients presenting with TBAAD from 2000 to 2018 at a single tertiary care center. The primary end-point was early (<3 months) and late (>3 months) survival following TBAAD, with causes of both early and late mortality evaluated.
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!