Factors leading to long-term hospitalization after laparoscopic appendectomy.
BACKGROUND
Randomized studies demonstrate that laparoscopic appendectomy yields better results compared with open techniques. We sought to identify factors that determine an extended hospital stay among patients undergoing laparoscopic appendectomy.


METHODS
This was a prospective study including 669 patients undergoing laparoscopic appendectomy. We analyzed variables that can predict the length of hospital stay.


RESULTS
Of 669 patients undergoing laparoscopic appendectomy, 141 stayed in the hospital for > or = 5 days (Group 1), and 97 stayed in the hospital for < or = 1 day after surgery (Group 2). The univariate analysis demonstrated that fever (P<0.0001), nausea and vomiting (P=0.060), leukocytosis (P<0.0001), gangrened or perforated intraoperative appearance of the appendix (P<0.0001), and appendix position behind the ileocecal junction (P<0.001) were related to a longer hospital stay. The multivariate analysis through logistical regression showed that the factors independently and significantly associated with an extended hospital stay were presurgical fever, appendix position behind the ileocecal junction, and intraoperative gangrened or perforated appearance of the appendix.


CONCLUSIONS
Fever, appearance, and position of the appendix are factors related to an extended hospital stay.
do Amaral
Paulo Cezar Galvão
PC
General Surgery Division, São Rafael Hospital, Department of Surgery, Escola Bahiana de Medicina e Saúde Pública, Salvador, Bahia, Brazil. pcgamaral@terra.com.br
Filho
Euler de Medeiros Azaro
Ede M
Galvão
Thales Delmondes
TD
Junior
Eric Ettinger
EE
de Magalhães Neto
Galeno Egydio José
GE
Mascarenhas
Fabrício
F
Fahel
Edvaldo
E
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000379:methods*; D002648:Child; D005260:Female; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications; D011446:Prospective Studies; D012044:Regression Analysis