Risk factors for prolonged hospitalization and delayed treatment completion after laparoscopic appendectomy in patients with uncomplicated acute appendicitis

Abstract

Purpose: We sought to identify the risk factors for prolonged hospitalization and delayed treatment completion after lapa-roscopic appendectomy in patients with uncomplicated acute appendicitis.Methods: The study retrospectively analyzed 497 patients who underwent laparoscopic appendectomies for uncompli-cated appendicitis between January 2018 and December 2020. The patients were divided into an early discharge group ( <= 2 days) and a late discharge group (> 2 days) based on the length of hospital stay (LOS). The patients were also divided into uneventful and complicated groups according to the need for additional treatment after standard follow-up.Results: Thirty-seven patients (7.4%) were included in the late discharge group. The mean LOS of the late discharge groups was 3.9 days. There were significant differences according to age, preoperative C-reactive protein (CRP), and op-erative time between the 2 groups. Only operative time was significantly associated with prolonged LOS in multivariate analysis. Thirty-five patients (7.0%) were included in the complicated group. The mean duration of treatment in the un-eventful and complicated groups was 7.4 and 25.3 days, respectively. Significant differences existed between the unevent-ful and complicated groups in preoperative body temperature, preoperative CRP levels, maximal appendix diameter, and the presence of appendicoliths. In multivariate analysis, preoperative CRP levels and maximal appendix diameter were in-dependent predictors of delayed treatment completion.Conclusion: Shorter operative time is desirable to ensure minimal hospital stay in patients with uncomplicated appendici-tis. Further efforts are needed to ensure that patients with uncomplicated appendicitis do not experience delayed treat-ment completion after laparoscopic appendectomies.