TY - JOUR
T1 - Impact of outpatient management following appendectomy for acute appendicitis
T2 - An ACS NSQIP-P analysis
AU - Litz, Cristen N.
AU - Stone, Laurie
AU - Alessi, Roberta
AU - Walford, Nebbie E.
AU - Danielson, Paul D.
AU - Chandler, Nicole M.
PY - 2018/4
Y1 - 2018/4
N2 - Background: In 2012, a same-day discharge protocol following appendectomy for acute appendicitis was initiated. Our objective was to determine the success of the protocol by reviewing the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) outcomes following protocol development. Methods: The 2015 NSQIP-P Participant Use Data File was queried to identify patients with acute appendicitis who underwent appendectomy. Outcomes were compared to institutional outcomes. Results: There were 154 institutional patients and 4973 from NSQIP-P centers. Institutional rate of outpatient management was higher compared to NSQIP-P (84% vs 48%, p < 0.0001). Surgical length of stay was shorter compared to national rates (0.3 ± 0.7 vs 1.1 ± 1.9 days, p < 0.0001). There was no significant difference in the incidence of superficial (1.9% vs 1.0%, p = 0.2), deep (0.6% vs 0.1%, p = 0.17) or organ/space surgical site infections (1.3% vs 0.7%, p = 0.31). The incidences of other complications (1.3% vs 0.6%, p = 0.26) and 30-day readmissions (3.2% vs 2.6%, p = 0.61) were similar. Conclusion: Outpatient management following appendectomy in children is possible with low morbidity and readmission rates. Comparison with other NSQIP-Pediatric centers suggests an opportunity to generalize this practice with considerable savings to the health care system. Level of evidence: Prognosis study, level II.
AB - Background: In 2012, a same-day discharge protocol following appendectomy for acute appendicitis was initiated. Our objective was to determine the success of the protocol by reviewing the National Surgical Quality Improvement Program-Pediatric (NSQIP-P) outcomes following protocol development. Methods: The 2015 NSQIP-P Participant Use Data File was queried to identify patients with acute appendicitis who underwent appendectomy. Outcomes were compared to institutional outcomes. Results: There were 154 institutional patients and 4973 from NSQIP-P centers. Institutional rate of outpatient management was higher compared to NSQIP-P (84% vs 48%, p < 0.0001). Surgical length of stay was shorter compared to national rates (0.3 ± 0.7 vs 1.1 ± 1.9 days, p < 0.0001). There was no significant difference in the incidence of superficial (1.9% vs 1.0%, p = 0.2), deep (0.6% vs 0.1%, p = 0.17) or organ/space surgical site infections (1.3% vs 0.7%, p = 0.31). The incidences of other complications (1.3% vs 0.6%, p = 0.26) and 30-day readmissions (3.2% vs 2.6%, p = 0.61) were similar. Conclusion: Outpatient management following appendectomy in children is possible with low morbidity and readmission rates. Comparison with other NSQIP-Pediatric centers suggests an opportunity to generalize this practice with considerable savings to the health care system. Level of evidence: Prognosis study, level II.
KW - Laparoscopic appendectomy
KW - NSQIP-p
KW - Outpatient management
KW - Pediatric
KW - Same day discharge
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U2 - 10.1016/j.jpedsurg.2017.06.023
DO - 10.1016/j.jpedsurg.2017.06.023
M3 - Article
C2 - 28693849
AN - SCOPUS:85021892246
SN - 0022-3468
VL - 53
SP - 625
EP - 628
JO - Journal of pediatric surgery
JF - Journal of pediatric surgery
IS - 4
ER -