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[S073]-The impact of interval appendectomy timing on follow-up adverse outcomes.
Noubani, Mohammad; McCarthy, Elizabeth; Zhang, Xiaoyue; Yang, Jie; Spaniolas, Konstantinos; Pryor, Aurora D; Powers, Kinga.
Afiliação
  • Noubani M; Department of Surgery, Health Sciences Center, Stony Brook University Hospital, 182 Christian Ave., Stony Brook, NY, 11790, USA. mohammad.noubani@stonybrookmedicine.edu.
  • McCarthy E; Department of Surgery, Health Sciences Center, Stony Brook University Hospital, 182 Christian Ave., Stony Brook, NY, 11790, USA.
  • Zhang X; Department of Family, Population and Preventative Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA.
  • Yang J; Department of Family, Population and Preventative Medicine, Stony Brook University Medical Center, Stony Brook, NY, USA.
  • Spaniolas K; Department of Surgery, Health Sciences Center, Stony Brook University Hospital, 182 Christian Ave., Stony Brook, NY, 11790, USA.
  • Pryor AD; Department of Surgery, Health Sciences Center, Stony Brook University Hospital, 182 Christian Ave., Stony Brook, NY, 11790, USA.
  • Powers K; Department of Surgery, Health Sciences Center, Stony Brook University Hospital, 182 Christian Ave., Stony Brook, NY, 11790, USA.
Surg Endosc ; 37(4): 3154-3161, 2023 04.
Article em En | MEDLINE | ID: mdl-35962228
OBJECTIVE: This study aims to compare the timing of interval appendectomy (IA) and its impact on post-operative outcomes. METHODS: A retrospective analysis was performed for adult patients diagnosed with appendicitis between 2006 and 2017. IA was defined as a follow-up appendectomy > 1 week and < 2 years after the initial presentation. Time intervals were divided into 4 groups based on patient quartiles: 1-6 weeks, 7-9 weeks, 10-15 weeks, and > 15 weeks. The primary outcome measure was length of stay (LOS). Secondary outcomes included 30-day readmission and IA post-operative complications. Tertiary outcomes included 30-day mortality and colonoscopy suggesting neoplasm or Inflammatory Bowel Disease. RESULTS: A total of 5069 patients' records whose interval appendectomy fell > 1 week and < 2 years after initial presentation were analyzed. Among them, 1006 (19.85%) underwent an initial percutaneous abscess drainage at diagnosis. The median timing for IA was 9.2 weeks. Patients with IA at 1-6 weeks were more likely to have longer LOS when compared to 7-9 weeks (ratio 1.33, 95% CI 1.2-1.48) and 10-15 weeks (ratio 1.38, 95% CI 1.25-1.52). IA between 7 and 9 weeks (ratio 0.81, 95% CI 0.73-0.89) and 10-15 weeks (ratio 0.78, 95% CI 0.71-0.86) was associated with significantly shorter LOS compared to those receiving the operation after 15 weeks. Further, patients requiring abscess drainage (ratio 1.2, 95% CI 1.13-1.34) or those with comorbidities (ratio 1.51, 95% CI 1.39-1.63) were more likely to have longer LOS at IA. Socioeconomic and demographic differences including Black, Hispanic, and those with Medicare and Medicaid insurance had a greater LOS after their IA. CONCLUSION: LOS remains lowest among patients undergoing IA between 7-9 weeks and 10-15 weeks after initial appendicitis presentation. Patients with lower socioeconomic status or from racial minorities had a longer LOS after IA.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apendicectomia / Apendicite Limite: Adult / Aged / Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Apendicectomia / Apendicite Limite: Adult / Aged / Humans País/Região como assunto: America do norte Idioma: En Ano de publicação: 2023 Tipo de documento: Article