Appendectomy Timing

• DOI: 10.1097/sla.0b013e318265ea13
• Publication Date: 2012-07-28T12:00:01Z
• Authors: Pedro G. Teixeira; Emre Sivrikoz; Kenji Inaba; Peep Talving; Lydia Lam; Demetrios Demetri...
• Keywords: Perforation; Leukocytosis; White blood cell

In Brief Objective: To investigate the association between time from admission to appendectomy (TTA) and incidence of perforation infectious complications. Background: Immediate prevent has been challenged by recent studies supporting a semielective approach acute appendicitis. Methods: Patients admitted with appendicitis July 2003 June 2011 were reviewed. Age, sex, white blood cell count, surgical (open vs laparoscopic), TTA, pathology report abstracted. Primary outcomes included site infection (SSI). Logistic regression was performed both identify independent predictors TTA SSI. Results: Over 8 years, 4529 patients 4108 (91%) underwent appendectomy. Perforation occurred in 23% (n = 942) these patients. identified 3 perforation: age 55 years or older [odds ratio (95% confidence interval) OR CI), 1.66 (1.21–2.29); P 0.002], count more than 16,000 [OR 1.38 (1.15–1.64); < 0.001], female sex 1.20 (1.02–1.41); 0.02]. Delay not associated higher rate. However, after controlling for age, leukocytosis, laparoscopic approach, perforation, 6 hours independently an increase SSI 1.54 (1.01–2.34); 0.04]. resulted significant 1.9% 3.3% among nonperforated 2.16 (1.03–4.52); 0.03], raising levels similar those (3.3% 3.9%, 0.47). Conclusions: this series, delay did risk but significantly increased Prompt intervention is warranted avoid additional morbidity population. This review consecutive appendectomies investigated rate infections. The findings suggest that infections