S073]-The impact of interval appendectomy timing on follow-up adverse outcomes.

Abstract

This study aims to compare the timing of interval appendectomy (IA) and its impact on post-operative outcomes. A retrospective analysis was performed for adult patients diagnosed with appendicitis between 2006 and 2017. IA was defined as a follow-up appendectomy > 1week and < 2years after the initial presentation. Time intervals were divided into 4 groups based on patient quartiles: 1-6weeks, 7-9weeks, 10-15weeks, and > 15weeks. The primary outcome measure was length of stay (LOS). Secondary outcomes included 30-day readmission and IA post-operative complications. Tertiary outcomes included 30-day mortality and colonoscopy suggesting neoplasm or Inflammatory Bowel Disease. A total of 5069 patients' records whose interval appendectomy fell > 1week and < 2 years after initial presentation were analyzed. Among them, 1006 (19.85%) underwent an initial percutaneous abscess drainage at diagnosis. The median timing for IA was 9.2weeks. Patients with IA at 1-6weeks were more likely to have longer LOS when compared to 7-9weeks (ratio 1.33, 95% CI 1.2-1.48) and 10-15weeks (ratio 1.38, 95% CI 1.25-1.52). IA between 7 and 9weeks (ratio 0.81, 95% CI 0.73-0.89) and 10-15weeks (ratio 0.78, 95% CI 0.71-0.86) was associated with significantly shorter LOS compared to those receiving the operation after 15weeks. Further, patients requiring abscess drainage (ratio 1.2, 95% CI 1.13-1.34) or those with comorbidities (ratio 1.51, 95% CI 1.39-1.63) were more likely to have longer LOS at IA. Socioeconomic and demographic differences including Black, Hispanic, and those with Medicare and Medicaid insurance had a greater LOS after their IA. LOS remains lowest among patients undergoing IA between 7-9weeks and 10-15weeks after initial appendicitis presentation. Patients with lower socioeconomic status or from racial minorities had a longer LOS after IA.