Risk of Complicated Appendicitis and Complications: Time to Hospital or Time to Surgery?
Journal
Journal of Society of Colon and Rectal Surgeons, Taiwan
Journal Volume
29
Journal Issue
2
Pages
84
Date Issued
2016-06
Author(s)
Abstract
Purpose. Acute appendicitis is a common cause of acute abdomen requiring surgery. However, it remains controversial whether patients may benefit from early appendectomy. The timing of appendectomy is determined by the time from the onset of symptoms to reaching the hospital (time to hospital) and the time from reaching the hospital to entering the operating room (time to surgery). We aimed to evaluate which period increases the risk for complicated appendicitis and postoperative complications. Methods. We retrospectively reviewed patients who underwent appendectomy for acute appendicitis from December 2015 to December 2016. The demographic characteristics were collected. The patients were divided into two groups: abdominal pain duration (time to hospital) ＞ 1 day and _ 1 day. From each group, the patients were further divided into two subgroups: time to surgery ＞ 12 h and _ 12 h. The disease severity and surgical outcome were respectively compared. Results. Among the 228 patients studied, 171 and 57 had abdominal pain for _ 1 and ＞ 1 day, respectively. Abdominal pain duration (time to hospital) of ＞ 1 day significantly increased the rates of complicated appendicitis (48.1% vs. 26.9%), operative time (78.8 vs. 61.4 min), post-operative hospital admission (5.1 vs. 3.4 days), overall hospital stay (5.8 vs. 4.1 days), and risk of intra-abdominal abscess (7% vs. 0.6%). Regardless of the time to hospital, operative time, disease severity, post-operative hospital admission, and complications were not significantly different between groups with time to surgery of ＞ 12 and ≤ 12 h. Conclusions. Prolonged abdominal pain duration (＞ 1 day) was associated with an increased risk of complicated appendicitis, longer operative time, post-operative hospital admission, overall hospital stay, and intraabdominal abscess. Regardless of abdominal pain duration, the time to surgery did not significantly affect the disease progression or postoperative complication rates. Our results suggested that the time to hospital has a more important role than time to surgery in the treatment outcome of acute appendicitis.
Subjects
Appendicitis
Time to surgery
Time to hospital
Complicated
Complication
Type
journal article