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Effect of in-hospital delay on acute appendicitis severity: does time really matter?
Agnesi, Stefano; Mauro Di Lucca, Gabriele; Benedetti, Fabio; Fattori, Luca; Degrate, Luca; Roccamatisi, Linda; Braga, Marco; Ceresoli, Marco.
Affiliation
  • Agnesi S; Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy.
  • Mauro Di Lucca G; Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy.
  • Benedetti F; Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy.
  • Fattori L; Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy.
  • Degrate L; Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy.
  • Roccamatisi L; Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy.
  • Braga M; Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy.
  • Ceresoli M; Department of General and Emergency Surgery, School of Medicine and Surgery, University of Milano-Bicocca, 20900, Monza, Italy. marco.ceresoli@unimib.it.
Updates Surg ; 2024 Apr 02.
Article in En | MEDLINE | ID: mdl-38565830
ABSTRACT
Appendicitis is one of the most common abdominal emergencies. Evidence is controversial in determining if the in-hospital time delay to surgery can worsen the clinical presentation of appendicitis. This study aimed to clarify if in-hospital surgical delay significantly affected the proportion of complicated appendicitis in a large prospective cohort of patients treated with appendectomy for acute appendicitis. Patients were grouped into low, medium, and high preoperative risk for acute appendicitis based on the Alvarado scoring system. Appendicitis was defined as complicated in cases of perforation, abscess, or diffuse peritonitis. The primary outcome was correlation of in-hospital delay with the proportion of complicated appendicitis. The study includes 804 patients 278 (30.4%) had complicated appendicitis and median time delay to surgery in low-, medium-, and high-risk group was 23.15 h (13.51-31.48), 18.47 h (10.44-29.42), and 13.04 (8.13-24.10) h, respectively. In-hospital delay was not associated with the severity of appendicitis or with the presence of postoperative complications. It appears reasonably safe to delay appendicectomy for acute appendicitis up to 24 h from hospital admission. Duration of symptoms was a predictor of complicated appendicitis and morbidity. Timing for appendicectomy in acute appendicitis should be calculated from symptoms onset rather than hospital presentation.
Key words

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Updates Surg Year: 2024 Document type: Article Affiliation country: Italy

Full text: 1 Collection: 01-internacional Database: MEDLINE Language: En Journal: Updates Surg Year: 2024 Document type: Article Affiliation country: Italy