When you think of someone in need of an appendectomy, you probably think of them being whisked off for emergency surgery as quickly as possible. For good reason: Appendectomies are the most common emergent surgical procedure performed worldwide.
A study reported in the September issue of the Archives of Surgery may change that way of thinking, however. The study indicates that when treating adults with acute appendicitis it is not harmful to delay appendectomy for 12 hours or more.
The study used data from 32,782 patients treated from Jan. 1, 2005, through Dec. 31, 2008. Of those patients, more than 75 percent had surgery within six hours of surgical admission, 15 percent had surgery within more than six to 12 hours after admission, and nearly 10 percent more than 12 hours after admission. There were no material differences in the 30-day outcomes for the patients who had surgery more than 12 hours after admission compared to those who had surgery sooner than 12 hours.
With an aging population, the need for emergent surgical care will continue to increase, as will the demand on resources of acute care surgeons and professional staff. Utilizing these resources to provide the best care for all patients necessitates that decisions be made as to which surgeries are critical and which can be delayed. Safely delaying appendectomies will free up resources to treat patients whose surgical needs are more critical.
In critiquing the report findings, John G. Hunter, M.D., of the Oregon Health & Science University in Portland said, “Financial savings without any evidence of adversity to the patient and the promise of a well-rested surgeon in the morning provide benefit sufficiently ample for me to embrace these recommendations. At the end of the day, it is clearly a win-win-win situation when the interests of the patient, the surgeon and the hospital are in complete alignment around such a shift in surgical practice.”