Laura A Boomer1, Jennifer N Cooper2, Katherine J Deans3, Peter C Minneci3, Karen Leonhart2, Karen A Diefenbach1, Brian D Kenney1, Gail E Besner4. 1. Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA. 2. Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. 3. Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA; Center for Surgical Outcomes Research, The Research Institute at Nationwide Children's Hospital, Columbus, OH, USA. 4. Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, OH, USA. Electronic address: gail.besner@nationwidechildrens.org.
Abstract
PURPOSE: The purpose of this study was to investigate the association between time from diagnosis to operation and surgical site infection (SSI) in children undergoing appendectomy. METHODS: Pediatric patients undergoing appendectomy in 2010-2012 were included. We collected data on patient demographics; length of symptoms; times of presentation, admission and surgery; antibiotic administration; operative findings; and occurrence of SSI. RESULTS: 1388 patients were analyzed. SSI occurred in 5.1% of all patients, 1.4% of simple appendicitis (SA) patients, and 12.4% of complex appendicitis (CA) patients. SSI did not increase significantly as the length of time between ED triage and operation increased (all patients, p=0.51; SA patients, p=0.91; CA patients, p=0.44) or with increased time from admission to operation (all patients, p=0.997; SA patients, p=0.69; CA patients, p=0.96). However, greater length of symptoms was associated with an increased risk of SSI (p<0.05 for all, SA and CA patients). In univariable analysis, obesity, and increased admission WBC count were each associated with significantly increased SSI. In multivariable analysis, only CA was a significant risk factor for SSI (p<0.0001). CONCLUSION: We found no significant increase in the risk of SSI related to delay in appendectomy. A future multi-institutional study is planned to confirm these results.
PURPOSE: The purpose of this study was to investigate the association between time from diagnosis to operation and surgical site infection (SSI) in children undergoing appendectomy. METHODS: Pediatric patients undergoing appendectomy in 2010-2012 were included. We collected data on patient demographics; length of symptoms; times of presentation, admission and surgery; antibiotic administration; operative findings; and occurrence of SSI. RESULTS: 1388 patients were analyzed. SSI occurred in 5.1% of all patients, 1.4% of simple appendicitis (SA) patients, and 12.4% of complex appendicitis (CA) patients. SSI did not increase significantly as the length of time between ED triage and operation increased (all patients, p=0.51; SA patients, p=0.91; CA patients, p=0.44) or with increased time from admission to operation (all patients, p=0.997; SA patients, p=0.69; CA patients, p=0.96). However, greater length of symptoms was associated with an increased risk of SSI (p<0.05 for all, SA and CA patients). In univariable analysis, obesity, and increased admission WBC count were each associated with significantly increased SSI. In multivariable analysis, only CA was a significant risk factor for SSI (p<0.0001). CONCLUSION: We found no significant increase in the risk of SSI related to delay in appendectomy. A future multi-institutional study is planned to confirm these results.
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Authors: Ramon R Gorter; Hasan H Eker; Marguerite A W Gorter-Stam; Gabor S A Abis; Amish Acharya; Marjolein Ankersmit; Stavros A Antoniou; Simone Arolfo; Benjamin Babic; Luigi Boni; Marlieke Bruntink; Dieuwertje A van Dam; Barbara Defoort; Charlotte L Deijen; F Borja DeLacy; Peter Mnyh Go; Annelieke M K Harmsen; Rick S van den Helder; Florin Iordache; Johannes C F Ket; Filip E Muysoms; M Mahir Ozmen; Michail Papoulas; Michael Rhodes; Jennifer Straatman; Mark Tenhagen; Victor Turrado; Andras Vereczkei; Ramon Vilallonga; Jort D Deelder; Jaap Bonjer Journal: Surg Endosc Date: 2016-09-22 Impact factor: 4.584