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September 1, 2010Archives of Surgery

Effect of Delay to Operation on Outcomes in Adults With Acute Appendicitis

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Key result

Delaying appendectomy for acute appendicitis for >12 hours did not significantly affect 30-day overall morbidity (6.1% vs 5.5%; P=0.33) compared to operation within 6 hours.

Why the study?

Does delay to operation increase 30-day morbidity and mortality in adults with acute appendicitis?

Population

32,782 adults with acute appendicitis who underwent an appendectomy

Comparison

Appendectomy performed >6 through 12 hours or… vs Appendectomy performed within 6 hours of…

Design

Cohort

Follow-up

30-day

Authors

AIAngela M. Ingraham

Discussion

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Overview

Delay >12h showed no morbidity increase in this cohort; leaves open whether timing affects outcomes or warrants practice change.

Study Design

Type

Cohort (n=32,782)

Multicenter

Yes

Structured PICO

Does delay to operation increase 30-day morbidity and mortality in adults with acute appendicitis?

P
Population
32,782 adults with acute appendicitis who underwent an appendectomy, evaluated for 30-day outcomes.
E
Exposure
Appendectomy performed >6 through 12 hours (n=4,934) or >12 hours (n=3,201) after surgical admission
C
Comparator
Appendectomy performed within 6 hours of surgical admission (n=24,647)
O
Outcome
Thirty-day overall morbidity and serious morbidity/mortalitycomposite

Main Result

Absolute Event Rate: 6.1% vs 5.5%

p-value: p=0.33

Delaying appendectomy for acute appendicitis up to or beyond 12 hours does not adversely affect 30-day outcomes, allowing for better allocation of emergency operative resources.

Limitations

  • Retrospective study design
  • Retrospective design

Cite This Study

Angela M. Ingraham (2010) conducted a cohort in acute appendicitis (n=32,782). Delay to operation (>12 hours) vs. Operation within 6 hours was evaluated on Thirty-day overall morbidity (p=0.33). Delaying appendectomy for acute appendicitis for >12 hours did not significantly affect 30-day overall morbidity (6.1% vs 5.5%; P=0.33) compared to operation within 6 hours.

synapsesocial.com/papers/6a818ec0b35cb7638cee1beahttps://doi.org/10.1001/archsurg.2010.184
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Also Consider

Synapse has enriched 4 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Nonsurgical Treatment of Appendiceal Abscess or Phlegmon2007 · 391 citations
  2. 2The Department of Veterans Affairs' NSQIP1998 · 1,536 citations
  3. 3Appendectomy1997 · 46 citations
  4. 4Is It Safe to Delay Appendectomy in Adults With Acute Appendicitis?2006 · 305 citations