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Risk Factors for Readmission After Short-Hospital-Stay Laparoscopic Appendectomy

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Single-day discharge is a common practice among patients undergoing laparoscopic appendectomy (LA). We aimed to determine risk factors associated with readmission in patients with short hospital stay after LA. We… Click to show full abstract

Single-day discharge is a common practice among patients undergoing laparoscopic appendectomy (LA). We aimed to determine risk factors associated with readmission in patients with short hospital stay after LA. We performed a retrospective analysis of all patients who underwent LA during the period 2006–2019. Patients with length of hospital stay shorter than 24 h were included. Demographics, operative variables, and postoperative outcomes were analyzed. Multivariable logistic regression was performed to determine risk factors for readmission. A total of 2009 LA were performed during the study period; 1506 (75%) patients had short hospital stay and were included in the analysis. Median age was 31 (14–85) years, and 720 (48%) were female. Mild peritonitis was diagnosed in 423 (28%) patients, and 121 (8%) had gangrenous/perforated appendicitis. Mean surgical time was 51(14–180) min. Conversion rate was 0.4%. There were 143 (9%) postoperative complications, including 29 (1.9%) patients with postoperative intra-abdominal abscess. Nine patients (0.6%) underwent reoperation, and only 26 (1.7%) patients were readmitted. The mean time to hospital readmission was 6 (1–14) days. Although age >50 years, obesity, mild peritonitis, and complicated appendicitis were more frequent among patients readmitted, only age >50 years (OR 3.54 95% CI 1.51–8.30) and mild peritonitis (OR 6.16 95% CI 1.80–34.93) were found as independent risk factors for readmission. Most patients undergoing LA can be safely discharged within 24 h of admission. Patients over 50 years old and/or with localized peritonitis have significantly higher risk of readmission and therefore may need a closer postoperative follow-up.

Keywords: risk; hospital stay; risk factors; factors readmission; short hospital

Journal Title: World Journal of Surgery
Year Published: 2020

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