International news on day procedures in the future: Appendectomy Patients Don’t Need an Overnight Stay

Researchers found little differences when they compared patients discharged on the day of an operation with those hospitalized overnight.

Journal of the American College of Surgeons

Published: November 16, 2016

Category: Outpatient Surgery > Surgical Research

SAME-DAY DISCHARGE It’s safe to discharge patients who undergo a laparoscopic appendectomy the same day of their operations, a study says.

An overnight hospital stay after an appendectomy? Not needed, say researchers, who found that same-day laparoscopic appendectomy patients don’t experience higher rates of post-operative complications or readmissions than patients who are hospitalized overnight. Their results were published online in the Journal of the American College of Surgeons.

Each year, more than 250,000 appendectomies are performed in the United States for acute appendicitis. Now that a study has found that same-day discharge in acute non-perforated appendicitis is a safe option, it’s expected that more of these patients will be sent home directly from the recovery room.

“Advances in early recognition and treatment of the disease process and minimally invasive techniques have allowed for some of the inflammatory response and the trauma from surgical treatment to be lessened and recovery to be faster; as a result, patients can get back to their lives much sooner,” says study principal investigator Armen Aboulian, MD, FACS, a colorectal surgeon at Kaiser Permanente, Woodland Hills, Calif., who adds that about 60% of non-perforated acute appendicitis patients at Kaiser Permanente are treated without an overnight stay.

Researchers analyzed the medical records of 12,703 patients who underwent a laparoscopic appendectomy for non-perforated appendicitis at 14 Southern California Region Kaiser Permanente medical centers between 2010 and 2014. Researchers compared the patients discharged on the day of surgery (6,710) with those hospitalized overnight (5,993). They found that the same-day group had similar return rates (2.2%) to emergency rooms or urgent care centers and an overall lower rate of readmission within 30 days when compared with those who were hospitalized overnight (3.1%).

Factors such as older age, serious health problems and a later procedure time (most surgeons would not discharge their patients from the recovery room late at night) increased the rate of overnight admissions.

“The goal of the study is not to rush the patients home, but rather, the importance of this study lies in the confirmation that discharge from the recovery room is safe and surgeons across the nation may consider it directly from the recovery room in the appropriate setting,” says Dr. Aboulian.

The study also showed that same-day discharge translates into an average direct cost savings of $348 per case within the Kaiser Permanente system.

Dan O’Connor

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