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PTU-229 Time to appendicectomy; is it predictive of morbidity?
  1. DFN Fung,
  2. R Mclean,
  3. I Mccallum
  1. General Surgery, Health Education North East, Newcastle, UK

Abstract

Introduction Prompt appendicectomy is advocated in the management of acute appendicitis as risks of perforation and its morbidity increases with time. This study aims to examine the morbidity of appendicectomy in relation to the time to surgery at our institution. Significant complications include surgical site infection and intraabdominal abscess.

Method This is a retrospective study of all appendicectomies performed in two major surgical units (Newcastle Upon Tyne and Gateshead Foundation Trust) between 2000 and 2014. Trust information department were contacted for access to data from administrative records on all emergency surgical admissions in the fourteen year period. All appendicectomies were identified using OPCS-4 procedure codes. Data was collected on patient demographic, time to appendicectomy, length of hospital stay, inpatient mortality and complications. The outcomes of appendicectomy were compared for patients who had surgery on day 0,1,2, >3 following admission.

Results A total of 2946 appendicectomies were performed for 1557 males and 1389 females with a mean age of 34 years. There were 1566 cases of open appendicectomy (53%), 1262 cases of laparoscopic appendicectomies (42.8%) and 118 cases required open conversion (open conversion rate 8.5%). There was no difference for surgical site infection (1.4% vs 1.1% vs 1.7% vs 0.9%, p = 0.65), intraabdominal abscess (0.1% vs 0.3% vs 0% vs 0% p = 0.99), open conversion (3.6% vs 4.4% vs 5.5% vs 0%, p = 0.75) and complications requiring intervention (0.1% vs 0.3% vs 0% vs 0%, p = 0.99). The median length of hospital stay was 3 days and the overall inpatient mortality 0.1%.

Conclusion An early decision for appendicectomy has been mainstream practice although there is no evidence in this study to suggest the time to surgery is an independent factor predictive of the morbidity of appendicectomy.

Disclosure of interest None Declared.

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