WP5.12 - Assessing the safety of managing and discharging appendicitis patients within 24 hours of presentation to hospital

Abstract

Abstract Aims Acute appendicitis (AA) has an incidence of 81 per 100,000 person-years and is a common reason for admission in acute general surgery units. Laparoscopic appendicectomy (LA) is well established as the main treatment method for patients with AA and many are deemed fit for discharge soon after this operation. This study aimed to assess the proportion of AA patients who underwent LA who were able to be successfully discharged within 24 hours of their surgery. Methods The notes from AA patients admitted to Royal Sussex County Hospital between December 2021 and December 2023 were retrospectively analysed for their time to post-operative discharge. Within this group, cases who were uncomplicated and who could be discharged within 8 hours of surgery were noted. The notes were further assessed for patients who required readmission within 24 hours of surgery. Results 462 cases of AA admitted were identified and of these, 152 (32.9%) underwent LA and were discharged within 24 hours of admission. 91 (59.8%) of this subgroup were discharged within 8 hours and 81 (53.3%) had uncomplicated appendicitis. None of these cohorts of patients were readmitted within 24 hours. Conclusions Discharging patients within 8 hours of LA was shown to be a safe option for patients who underwent surgery. The findings in this study suggest that pathways encouraging the prompt assessment and management of appendicitis cases should be considered in all hospitals to facilitate effective patient flow.