Stefano Agnesi (Monza / IT), Gabriele Mauro Di Lucca (Monza / IT), Fabio Benedetti (Monza / IT), Maria Rennis (Monza / IT), Luca Fattori (Monza / IT), Luca Degrate (Monza / IT), Stefano Perrone (Monza / IT), Marco Cereda (Monza / IT), Linda Roccamatisi (Monza / IT), Giulia Lobianco (Monza / IT), Marco Braga (Monza / IT), Marco Ceresoli (Monza / IT)
Abstract text (incl. references and figure legends)
Introduction
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, with a larger proportion of complicated appendicitis and subsequent increased morbidity. 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.
Materials and Methods
This is an analysis of a prospectively collected register of all consecutive patients treated with appendectomy at our center for acute appendicitis between 2013-2021. Patients were stratified according to the Alvarado score predicted risk of acute appendicitis: the low risk group included patients with a score from 0 to 3, medium risk from 4 to 6 and high risk from 7 to 10. Appendicitis were defined as complicated in case of perforated and necrotic appendicitis, peritoneal abscess or peritonitis. The primary outcome was correlation of in-hospital delay with the proportion of complicated appendicitis.
Results
The study included 916 patients: 559 were male (61%) and median age was 24 (14-46). 278 (30.4%) had complicated appendicitis. Median time delay to surgery was 19.6 hours (11.2-30.3) for the uncomplicated appendicitis group and 19.3 hours for the complicated group. In each Alvarado risk group in-hospital delay to surgery was not associated with the presence of complicated appendicitis [OR(CI 95%) low risk: 1.002(0.994-1.009); medium risk: 1.005(0.994-1.016); high risk: 1.004(0.982-1.025)]. No significant correlation was observed between time delay and severity of complications, using Clavien Dindo Classification and Comprehensive Complication Index.
Conclusions
In-hospital delay was not associated with an increased proportion of complicated acute appendicitis.
Disclosure: Do you have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstract? (If not, please enter "No" in the text field.)
No