Same-day discharge after appendectomy for uncomplicated appendicitis in children: Potential barriers to increased utilization

Am J Surg. 2022 Jul;224(1 Pt B):629-634. doi: 10.1016/j.amjsurg.2022.03.051. Epub 2022 Apr 5.

Abstract

Background: Utilization of same-day discharge (SDD) after appendectomy for uncomplicated appendicitis (UA) was closely examined to explore potential barriers to greater use of SDD.

Methods: Children (≤18 years) who underwent appendectomy for UA between 2015 and 2019 at a tertiary care children's hospital were reviewed. Associations with SDD were evaluated using multivariable regression models.

Results: Among 973 children, SDD was less frequently utilized after appendectomy performed between 12pm and 5pm (aOR 0.14, p < 0.001) and after 5pm (aOR 0.01, p < 0.001) compared to before 12pm. SDD utilization was also less frequent in those from lower resource neighborhoods (adjusted odds ratio [aOR] 0.90 per decile increase in Area Deprivation Index, p = 0.04), females (aOR 0.53, p = 0.005), and patients residing 30-60 min away (aOR 0.56, p = 0.04) compared to <30 min away.

Conclusions: SDD utilization was primarily impacted by operative timing and socioeconomic and travel factors, focuses for quality improvement efforts to further increase utilization of SDD.

Keywords: Appendicitis; Children; Outcomes; Value.

MeSH terms

  • Appendectomy*
  • Appendicitis / surgery
  • Child
  • Female
  • Humans
  • Length of Stay
  • Male
  • Patient Discharge*