Academic Journal
Associations Between Time-To-Surgery and Postoperative Length of Stay and Complications in Patients With Acute Appendicitis.
| Τίτλος: | Associations Between Time-To-Surgery and Postoperative Length of Stay and Complications in Patients With Acute Appendicitis. |
|---|---|
| Συγγραφείς: | Jepsen AH; Department of Anesthesiology and Intensive Care, Copenhagen University Hospital - North Zealand, Hillerød, Denmark., Ipsen EØ; Department of Anesthesiology and Intensive Care, Copenhagen University Hospital - North Zealand, Hillerød, Denmark., Finne KF; Department of Surgery, Copenhagen University Hospital-North Zealand, Hillerød, Denmark., Knudsen RL; Department of Anesthesiology and Intensive Care, Copenhagen University Hospital - North Zealand, Hillerød, Denmark., Frølund Bjulf RH; Department of Anesthesiology and Intensive Care, Copenhagen University Hospital - North Zealand, Hillerød, Denmark., Bahuet AR; Department of Anesthesiology and Intensive Care, Copenhagen University Hospital - North Zealand, Hillerød, Denmark., Bertelsen CA; Department of Surgery, Copenhagen University Hospital-North Zealand, Hillerød, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Wiborg Lange KH; Department of Anesthesiology and Intensive Care, Copenhagen University Hospital - North Zealand, Hillerød, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Højer Karlsen AP; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.; Department of Anesthesiology and Intensive Care Medicine, Copenhagen University Hospital-Bispebjerg, Bispebjerg, Denmark., Olsen MH; Department of Anesthesiology and Intensive Care Medicine, Copenhagen University Hospital-Bispebjerg, Bispebjerg, Denmark.; Department of Neuroanaesthesiology, The Neuroscience Centre, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark.; Copenhagen Trial Unit, Centre for Clinical Intervention Research, The Capital Region, Copenhagen University Hospital-Rigshospitalet, Copenhagen, Denmark., Kleif J; Department of Surgery, Copenhagen University Hospital-North Zealand, Hillerød, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Lundstrøm LH; Department of Anesthesiology and Intensive Care, Copenhagen University Hospital - North Zealand, Hillerød, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark., Nørskov AK; Department of Anesthesiology and Intensive Care, Copenhagen University Hospital - North Zealand, Hillerød, Denmark.; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark. |
| Πηγή: | World journal of surgery [World J Surg] 2026 Sep; Vol. 50 (9), pp. 2609-2624. Date of Electronic Publication: 2026 Aug 06. |
| Τύπος έκδοσης: | Journal Article; Observational Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley Country of Publication: United States NLM ID: 7704052 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1432-2323 (Electronic) Linking ISSN: 03642313 NLM ISO Abbreviation: World J Surg Subsets: MEDLINE |
| Imprint Name(s): | Publication: 2024- : [Hoboken, NJ] : Wiley Original Publication: New York, Springer International. |
| Ιατρικοί όροι (MeSH): | Appendicitis*/surgery , Length of Stay*/statistics & numerical data , Appendectomy*/methods , Postoperative Complications*/epidemiology , Postoperative Complications*/etiology , Time-to-Treatment*/statistics & numerical data , Laparoscopy*, Denmark/epidemiology ; Humans ; Female ; Retrospective Studies ; Male ; Adult ; Adolescent ; Middle Aged ; Young Adult ; Acute Disease ; Time Factors |
| Περίληψη: | Introduction: Acute appendicitis is a common surgical emergency. The optimal time-to-surgery interval remains debated, as studies reported increased complication risk beyond 12 or 24 hours respectively. We hypothesized that time-to-surgery of up to 24 hours after admission was not associated with increased postoperative length of stay (LOS) or complications. Methods: This retrospective observational cohort study included adults and adolescents (≥ 15 years) undergoing laparoscopic appendectomy from January 2017-July 2025 in the Capital and the Zealand Regions of Denmark. Data were extracted from the Electronic Health Record system. The primary exposure was time-to-surgery intervals. Primary outcome was postoperative LOS. Secondary outcomes were 30-day postoperative complications. Subgroup analyses were performed for uncomplicated/complicated appendicitis. All outcomes were evaluated by multivariable regression models adjusted for predefined confounders. Results: Of 25,417 laparoscopic appendectomies, 19,089 met eligibility criteria. Compared with time-to-surgery < 8 hours, postoperative LOS was reduced when time-to-surgery was 8-16 hours (mean difference -2.29 hours, 95% CI: -3.85 to -0.73) and 16-24 hours (-3.92 hours, 95% CI: -6.05 to -1.78). Compared with time-to-surgery < 8 hours, odds of postoperative complications were reduced for time-to-surgery up to 24 hours, whereas ≥ 36 hours was associated with increased odds (OR 1.57, 95% CI: 1.13 to 2.18). In complicated appendicitis, time-to-surgery 24-36 hours was associated with decreased postoperative LOS (-13.0 hours, 95% CI: -22 to -3.6). Conclusion: Time-to-surgery of up to 24 hours was not associated with increased postoperative LOS or complications. In contrast, we observed a protective association driven by complicated appendicitis, potentially reflecting effective clinical triage. (© 2026 International Society of Surgery/Société Internationale de Chirurgie (ISS/SIC). All rights reserved, including rights for text and data mining and training of artificial intelligence technologies or similar technologies.) |
| References: | Dan Med J. 2023 Nov 23;70(12):. (PMID: 38018705) Diagnostics (Basel). 2022 Jul 15;12(7):. (PMID: 35885627) Acta Anaesthesiol Scand. 2025 Oct;69(9):e70116. (PMID: 40923322) Eur J Trauma Emerg Surg. 2024 Jun;50(3):791-798. (PMID: 38049568) World J Surg. 2026 Sep;50(9):2609-2624. (PMID: 42559974) World J Emerg Surg. 2020 Apr 15;15(1):27. (PMID: 32295644) BMJ. 2007 Oct 20;335(7624):806-8. (PMID: 17947786) J Gastrointest Surg. 2022 May;26(5):1063-1069. (PMID: 35048258) Ann Surg. 2024 Jan 1;279(1):88-93. (PMID: 37436871) Eur J Trauma Emerg Surg. 2023 Jun;49(3):1355-1366. (PMID: 36708422) World J Emerg Surg. 2024 Jun 14;19(1):24. (PMID: 38877592) Eur J Trauma Emerg Surg. 2022 Oct;48(5):3879-3886. (PMID: 35211772) Lancet. 2023 Oct 28;402(10412):1552-1561. (PMID: 37717589) J Surg Res. 2018 Sep;229:234-242. (PMID: 29936996) Scand J Surg. 2021 Dec;110(4):512-519. (PMID: 33563095) Eur J Pediatr Surg. 2021 Aug;31(4):347-352. (PMID: 32869225) Br J Surg. 2018 Jul;105(8):933-945. (PMID: 29902346) J Trauma Acute Care Surg. 2018 Aug;85(2):341-347. (PMID: 29787550) Int J Surg. 2020 Apr;76:16-24. (PMID: 32068181) JAMA. 2026 Mar 24;335(12):1041-1049. (PMID: 41563747) Lancet Gastroenterol Hepatol. 2025 Mar;10(3):222-233. (PMID: 39827891) World J Surg. 2011 Jul;35(7):1626-33. (PMID: 21562871) Surgery. 2022 Sep;172(3):798-806. (PMID: 35850731) |
| Contributed Indexing: | Keywords: delay; postoperative complications; postoperative length of stay (LOS); time‐to‐surgery |
| Entry Date(s): | Date Created: 20260806 Date Completed: 20260915 Latest Revision: 20260922 |
| Update Code: | 20260922 |
| PubMed Central ID: | PMC13576577 |
| DOI: | 10.1002/wjs.70506 |
| PMID: | 42559974 |
| Βάση Δεδομένων: | MEDLINE |
καταχωρήστε σχόλιο πρώτοι!