Unplanned readmission and outpatient examination 90-days after acute appendectomy in adults

Am J Surg. 2018 Aug;216(2):217-221. doi: 10.1016/j.amjsurg.2017.07.020. Epub 2017 Jul 21.

Abstract

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.

Keywords: Acute; Appendectomy; Appendicitis; Readmission.

MeSH terms

  • Acute Disease
  • Adult
  • Appendectomy / adverse effects*
  • Appendicitis / surgery*
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Norway / epidemiology
  • Patient Readmission / trends*
  • Postoperative Complications / epidemiology*
  • Retrospective Studies
  • Risk Factors
  • Time Factors