Langenbeck's archives of surgery
Safety of in-hospital delay of appendectomy in complicated appendicitis - a propensity score-matched analysis of 1027 patients
By Anthuber L, Hoffmann M, Schiele S and 7 others.
Abstract
Introduction
Appendectomy is one of the most frequently performed emergency surgical procedures worldwide. Current guidelines recommend surgical intervention within 24 h for uncomplicated appendicitis; however, the optimal timing for patients with complicated appendicitis remains unclear. Recent studies suggest that in-hospital delay may be safe in uncomplicated cases, yet patients with clinical or radiological signs of perforation are usually excluded. This study aims to identify clinical and laboratory risk factors for perforation and to evaluate whether it is safe to delay surgery by 6 to 9 h in patients presenting with signs of complicated appendicitis.
Methods
This retrospective single-center study included patients who underwent emergency surgery for complicated appendicitis between January 2008 and June 2023. Perforation was defined histopathologically, and complications were recorded perioperatively. Multivariable logistic regression was used to identify independent risk factors for perforation and complications. Propensity-score (PS) matching was performed to control confounding factors.