Early Discharge After Appendectomy for Uncomplicated Acute Appendicitis was Associated with Lower Hospital Costs and Comparable Short-Term Outcomes: A Large Real-World Cohort Study

The safety of early discharge (≤ 8 h) and its impact on healthcare costs in patients with uncomplicated acute appendicitis remain controversial. This study aimed to evaluate the effects of different discharge times on short-term clinical outcomes and hospital costs using real-world data. A total of 1,557 consecutive patients who underwent appendectomy for uncomplicated acute appendicitis at a single center between 2019 and 2025 were retrospectively analyzed. Patients were divided into three groups according to discharge time: ≤8 h, 8–24 h, and ≥ 24 h. The primary endpoint was any complication within 30 days. Secondary endpoints included hospital readmission and total hospital costs. The overall complication rate was 1.6%. No significant differences were observed in overall complications ( p = 0.156), readmission ( p = 0.198) or specific complication rates according to discharge time. Patients discharged after ≥ 24 h were older ( p = 0.037). No significant differences were observed in comorbidity rates across discharge groups. Hospital costs increased significantly with longer discharge times ( p < 0.001). In this selected retrospective cohort, early discharge (≤ 8 h) was not associated with worse short-term outcomes or higher readmission rates. Longer hospital stay was associated with higher hospital costs. These findings suggest that, with careful patient selection and standardized perioperative management, early discharge may improve system efficiency without apparent short-term disadvantage.