Complicated appendicitis and surgical site infection associated with prolonged hospital stay after appendectomy in a Peruvian hospital

Objective To identify factors associated with prolonged hospital stay after appendectomy for acute appendicitis in a Peruvian public hospital. Methods We conducted a retrospective case-control study of adults who underwent appendectomy for acute appendicitis at Hospital Jesús Nazareno, Ayacucho, Peru, between January 2021 and December 2024. Cases had a hospital stay of ≥5 days, corresponding to the 75th percentile of the institutional distribution, and controls had a stay of <5 days. From 96 eligible cases and 288 eligible controls, 73 patients from each group were selected by simple random sampling. Crude and adjusted odds ratios (ORs) with 95% confidence intervals (CIs) were estimated using logistic regression. Results Median hospital stay was 6.0 days (IQR, 5.0–9.0) among cases and 2.0 days (IQR, 2.0–3.0) among controls. Complicated appendicitis was more frequent among cases than controls (97.3% vs. 27.4%), as was surgical site infection (38.4% vs. 1.4%). After multivariable adjustment, complicated appendicitis (adjusted OR, 38.62; 95% CI, 7.78–191.82) and surgical site infection (adjusted OR, 9.58; 95% CI, 1.14–80.55) remained associated with prolonged hospital stay. Conclusion Complicated appendicitis and surgical site infection were associated with prolonged hospital stay after appendectomy. Because the timing of surgical site infection onset was not captured, its temporal relationship with prolonged stay cannot be established. Timely management of complicated appendicitis and adherence to perioperative infection-prevention practices may help reduce prolonged hospitalization.