Same-Day Discharge Safe for Appendicitis Patients

Patients who undergo laparoscopic appendectomy do not experience higher postoperative complications or readmission rates when discharged on the same day of their operation, according to a new study.

Researchers at the University of California, Los Angeles (UCLA; USA) and Kaiser Permanente (Woodland Hills, CA, USA) conducted a retrospective study of 12,703 adult patients from 14 Southern California Region Kaiser Permanente medical centers who underwent laparoscopic appendectomy for acute, non-perforated appendicitis between 2010 and 2014. The researchers compared outcomes in 6,710 patients discharged on the day of surgery with 5,993 patients who were hospitalized overnight.

Main outcomes and measures included readmission and complication rates, and postoperative diagnostic or therapeutic radiology visits. The results showed that patients in the same-day discharge group had a lower rate of readmission within 30 days (2.2%), when compared with the hospitalized group (3.1%). In both groups, postoperative rates of visits to emergency or radiology department for diagnostic or therapeutic imaging studies were similar. Postoperative general surgery department visits were slightly higher in the hospitalized group. The study was published on November 15, 2016, in the Journal of the American College of Surgeons.

“Advances in early recognition and treatment of the disease process and minimally invasive techniques have allowed for some of the inflammatory response and the trauma from surgical treatment to be lessened and recovery to be faster; as a result, patients can get back to their lives much sooner,” said lead author colorectal surgeon Armen Aboulian, MD, of Kaiser Permanente Woodland Hills. “In general, recovery at home is preferred by most patients, and sleeping in your own bed has benefits that are difficult to measure.”

“Now up to 60% of non-perforated acute appendicitis patients at Kaiser Permanente are treated without an overnight stay,” concluded Dr. Aboulian. “Two hundred years ago, the diagnosis of appendicitis had more than a 60% mortality rate. Now these patients are treated and don't even have to spend the night in the hospital. Medical treatment for this disorder has come a long way.”

Appendectomy is the surgical removal of the vermiform appendix. The procedure is normally performed as an emergency procedure, when the patient is suffering from acute appendicitis. In the absence of surgical facilities, intravenous antibiotics are used to delay or avoid the onset of sepsis. In some cases the appendicitis resolves completely; more often, an inflammatory mass forms around the appendix, causing transruptural flotation.

Related Links:
University of California, Los Angeles
Kaiser Permanente