Impact of outpatient management following appendectomy for acute appendicitis: An ACS NSQIP-P analysis

Cristen N. Litz, Laurie Stone, Roberta Alessi, Nebbie E. Walford, Paul D. Danielson, Nicole M. Chandler

Research output: Contribution to journalArticlepeer-review

Abstract

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.

Original languageEnglish (US)
Pages (from-to)625-628
Number of pages4
JournalJournal of pediatric surgery
Volume53
Issue number4
DOIs
StatePublished - Apr 2018

Keywords

  • Laparoscopic appendectomy
  • NSQIP-p
  • Outpatient management
  • Pediatric
  • Same day discharge

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

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