当前位置： SCI文献检索 > IRISH JOURNAL OF MEDICAL SCIENCE期刊下所有文献 > Factors influencing surgical management of acute appendicitis in a large university hospital without a dedicated emergency theatre.

Factors influencing surgical management of acute appendicitis in a large university hospital without a dedicated emergency theatre.

Abstract：

BACKGROUND:Acute appendicitis is the most common surgical emergency. Its management reflects the efficacy of acute care surgery. Limited theatre space is an escalating issue, especially without dedicated emergency theatre access. Pre-operative delays are associated with longer length of stay, higher costs and post-operative complications. AIMS:Calculate time to theatre (TTT) from admission to appendicectomy and investigate factors impacting TTT. METHODS:A retrospective review of all emergency appendicectomies from June 2017 to October 2018. Demographic, clinico-pathological and radiological data were extracted from electronic patient record. RESULTS:One hundred forty-eight patients underwent emergency appendicectomy during the study period. Fifty-six percent (n = 84) were male, and the median (range) age was 30.5 (17-76) years. Sixty-one percent had pre-operative imaging. The median (range) TTT was 18.37 (2-114) h; 7.5% (n = 11) waited > 48 h, 29.7% (n = 44) were operated on after 8 p.m. and 26% (n = 38) were done on elective lists. Male gender, admission CRP > 100 and admission before 12 p.m. significantly shortened TTT (p = 0.030, p = 0.004 and p = 0.001, respectively). However, pre-operative ultrasound, previous acute appendicitis and surgery on an elective list significantly prolonged TTT (p = 0.015 and p = 0.024, respectively). The median (range) LOS was 3 (1-24) nights. Ten percent (n = 15) had post-operative complications; however, longer TTT was not associated with higher complication rates (p = 0.196). CONCLUSIONS:This review highlights the impact of limited theatre access for on-call emergency admissions, with a significant portion of appendicectomies being done on elective lists or out-of-hours.

journal_name

Ir J Med Sci

journal_title

Irish journal of medical science

authors

Foley MP,MacLean M,Doyle C,Nugent T,Kelly ME,Narouz F,Mehigan B,McCormick P,Larkin J

doi

10.1007/s11845-019-02135-z

subject

Has Abstract

pub_date

2020-05-01 00:00:00

pages

649-653

issue

eissn

0021-1265

issn

1863-4362

pii

10.1007/s11845-019-02135-z

journal_volume

189

pub_type

杂志文章

在线工具

Factors influencing surgical management of acute appendicitis in a large university hospital without a dedicated emergency theatre.