Key result
Acute appendectomy performed during the night or evening was not associated with a significant difference in 30-day postoperative complications compared to daytime surgery (night OR 0.79, p=0.141).
Why the study?
Appendectomy is commonly performed around the clock, but whether acute appendectomy performed during the day, evening, and night is equally safe remained to be determined.
Does acute appendectomy performed during the evening or night increase postoperative complications compared to daytime surgery in patients with acute appendicitis?
Cohort (n=4,950)
No
Does acute appendectomy performed during the evening or night increase postoperative complications compared to daytime surgery in patients with acute appendicitis?
Odds Ratio: 0.79 (95% CI 0.58–1.08)
Absolute Event Rate: 5.6% vs 6.4%
p-value: p=0.141
Acute appendectomy performed during the evening or night is as safe as daytime surgery regarding postoperative complications and is associated with a shorter hospital stay.
May support flexible appendectomy timing without added complications; retrospective data leaves open need for prospective confirmation.
PURPOSE: Appendicitis is one of the most common acute surgical conditions globally, and hence appendectomy is a common procedure performed around the clock in many hospitals. The aim of the current study was to determine whether acute appendectomy due to acute appendicitis performed during day, evening, and night was equally safe, in terms of postoperative complications, readmission, death, and length of hospital stay. METHODS: A retrospective single-center cohort study, using a local quality register of all consecutive acute appendectomies performed at the Department of Surgery, Södersjukhuset, Stockholm, Sweden. During the study period from December 2015 to August 2022, 4950 patients were included. Risk of complications, readmission, and death were determined using multivariable logistic regression models. Association with length of hospital stay was determined using multiple linear regression. RESULTS: There was no significant difference in the associated risk of postoperative complications, readmission within 30 days, or death, regardless of when appendectomy was performed. Using daytime surgery as reference, hospital stay was shortened by 4.21 h (P = 0.008) for evening surgery and by 6.71 h (P < 0.001) for nightly surgery. CONCLUSION: Risks of postoperative complications, readmission, and death were similar regardless of when acute appendectomy was performed. However, surgery during evening and night was associated with shortened hospital stay, as compared to daytime surgery.
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Nyström et al. (2023) conducted a cohort in Acute appendicitis (n=4,950). Acute appendectomy during evening or night vs. Acute appendectomy during daytime was evaluated on Postoperative complications within 30 days (OR 0.79, 95% CI 0.58-1.08, p=0.141). Acute appendectomy performed during the night or evening was not associated with a significant difference in 30-day postoperative complications compared to daytime surgery (night OR 0.79, p=0.141).
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