Risk of perforation increases with delay in recognition and surgery for acute appendicitis

Dominic Papandria, Seth D. Goldstein, Daniel Rhee, Jose H. Salazar, Jamir Arlikar, Amany Gorgy, Gezzer Ortega, Yiyi Zhang, Fizan Abdullah

Research output: Contribution to journalArticle

Abstract

Background: Appendicitis remains a common indication for urgent surgical intervention in the United States, and early appendectomy has long been advocated to mitigate the risk of appendiceal perforation. To better quantify the risk of perforation associated with delayed operative timing, this study examines the impact of length of inpatient stay preceding surgery on rates of perforated appendicitis in both adults and children. Methods: This study was a cross-sectional analysis using the National Inpatient Sample and Kids' Inpatient Database from 1988-2008. We selected patients with a discharge diagnosis of acute appendicitis (perforated or nonperforated) and receiving appendectomy within 7 d after admission. Patients electively admitted or receiving drainage procedures before appendectomy were excluded. We analyzed perforation rates as a function of both age and length of inpatient hospitalization before appendectomy. Results: Of 683,590 patients with a discharge diagnosis of appendicitis, 30.3% were recorded as perforated. Over 80% of patients underwent appendectomy on the day of admission, approximately 18% of operations were performed on hospital days 2-4, and later operations accounted for

Original languageEnglish (US)
Pages (from-to)723-729
Number of pages7
JournalJournal of Surgical Research
Volume184
Issue number2
DOIs
StatePublished - Oct 2013

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Keywords

  • Acute appendicitis
  • Appendectomy
  • Delayed operation
  • Kids' Inpatient Database
  • National Inpatient Sample
  • Perforated appendicitis
  • Surgical outcomes

ASJC Scopus subject areas

  • Surgery

Cite this

Papandria, D., Goldstein, S. D., Rhee, D., Salazar, J. H., Arlikar, J., Gorgy, A., Ortega, G., Zhang, Y., & Abdullah, F. (2013). Risk of perforation increases with delay in recognition and surgery for acute appendicitis. Journal of Surgical Research, 184(2), 723-729. https://doi.org/10.1016/j.jss.2012.12.008