Does Incidental Appendectomy Increase the Risk of Complications after Abdominal Procedures?

ABSTRACT

Incidental appendectomy (IA) could potentially increase the risk of morbidity after abdominal procedures; however, such effect is not clearly established. The aim of our study is to test the association of IA with morbidity after abdominal procedures. We identified 743 (0.37%) IA among 199,233 abdominal procedures in the National Surgical Quality Improvement Program database (2005-2009). Cases with and without IA were matched on the index current procedural terminology code. Patient characteristics were compared using chi-squared test for categorical variables and Student t test for continuous variables. Multivariate logistic regression analysis was performed. Emergency and open surgeries were associated with performing IA. Multivariate analysis showed no association of IA with mortality [odds ratio (OR) = 0.51, 95% confidence interval (CI) = 0.26-1.02], overall morbidity (OR = 1.16, 95% CI = 0.92-1.47), or major morbidity (OR = 1.20, 95% CI = 0.99-1.48). However, IA increased overall morbidity among patients undergoing elective surgery (OR = 1.31, 95% CI = 1.03-1.68) or those ≥30 years old (OR = 1.23, 95% CI = 1.00-1.51). IA was also associated with higher wound complications (OR = 1.46, 95% CI = 1.05-2.03). In conclusion, IA is an uncommonly performed procedure that is associated with increased risk of postoperative wound complications and increased risk of overall morbidity in a selected patient population.