American journal of surgery · 2017
Unplanned readmission and outpatient examination 90-days after acute appendectomy in adults.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
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Bendvold Bo, Refsum Arne, Schjøth-Iversen Line, Bringedal Kjersti, Husby Anders, Brudvik Kristoffer Watten
Аннотация
BACKGROUND: The aim of this study was to determine the frequency and indications for unplanned readmission and outpatient examination after acute appendectomy.
METHODS: Adults who underwent acute appendectomy from 2008-2013 were included in the study and events occurring within 90-days from discharge recorded.
RESULTS: A total of 710 patients underwent surgery. The appendix was removed in 622 patients and post-discharge contact occurred in 99 (15.9%): readmission in 60 (9.6%), outpatient examination in 39 (6.3%). The main reasons for post-discharge contact were infection (n = 25; intraabdominal, n = 16; superficial) and abdominal pain of uncertain cause (n = 25). Use of prophylactic antibiotics was associated with lower rates of contact, 8.5% versus 20.9% (p = 0.006), respectively. Removal of non-inflamed appendix was borderline associated with higher rates of contact, 21.7% versus 8.0% (if left in-situ; p = 0.058), respectively.
CONCLUSIONS: A substantial number of patients underwent readmission or outpatient examination within 90-days after appendectomy in the current study. The procedure is common and attempts to prevent readmissions are important. Correct use of antibiotics and not removing a non-inflamed appendix may be key points.
METHODS: Adults who underwent acute appendectomy from 2008-2013 were included in the study and events occurring within 90-days from discharge recorded.
RESULTS: A total of 710 patients underwent surgery. The appendix was removed in 622 patients and post-discharge contact occurred in 99 (15.9%): readmission in 60 (9.6%), outpatient examination in 39 (6.3%). The main reasons for post-discharge contact were infection (n = 25; intraabdominal, n = 16; superficial) and abdominal pain of uncertain cause (n = 25). Use of prophylactic antibiotics was associated with lower rates of contact, 8.5% versus 20.9% (p = 0.006), respectively. Removal of non-inflamed appendix was borderline associated with higher rates of contact, 21.7% versus 8.0% (if left in-situ; p = 0.058), respectively.
CONCLUSIONS: A substantial number of patients underwent readmission or outpatient examination within 90-days after appendectomy in the current study. The procedure is common and attempts to prevent readmissions are important. Correct use of antibiotics and not removing a non-inflamed appendix may be key points.