Does inter-hospital transfer for emergency appendicectomy increase overall delay to operation, length of stay, or risk of advanced pathology compared to direct admission?
Patients with acute appendicitis can be safely assessed at one hospital site and transferred to another for surgery without adversely affecting overall time to operation or clinical outcomes.
Purpose Patients undergoing emergency appendicectomy incur various delays from the time of symptom onset to the time of discharge from hospital. The centralisation of hospital services over recent years has resulted in some patients who attend hospital as an emergency requiring transfer to a different site. An additional delay by way of transfer is thus incurred. The aim of this study was to test for association between various characterised delays with disease and patient outcomes. Design/methodology/approach Hospital Episode Statistics (HES) data were used to identify all patients admitted over a one‐year period undergoing appendicectomy. Demographic and time data were extracted from hospital databases and case notes. Findings A total of 247 patients were identified from HES data; 25 per cent of patients presented to hospital E necessitating transfer to hospital H. There was no evidence of an association between patient delays, surgeon delays or theatre delays with advanced pathology and complicated appendicitis was not associated with a longer post‐operative hospital stay. The delay to be seen by the surgeons was significantly longer if transferred from one hospital to another, but this did not contribute to a significant difference between the overall delay from admission to operation, overall length of stay or advanced pathology. Originality/value The individual delays along the clinical pathway in a patient presenting to hospital with acute appendicitis have been characterised. Patients with acute appendicitis can be safely assessed at one hospital‐site and transferred to another with emergency surgery provision without affecting the delay to operation.
Ward et al. (Tue,) studied this question.
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