Patient Satisfaction After Outpatient Appendectomy.
BACKGROUND
Outpatient laparoscopic appendectomy has been shown to be safe, with low morbidity and readmission rates, but whether outpatient appendectomy produces poorer patient satisfaction has been questioned.


METHODS
Preoperatively, patients with uncomplicated appendicitis were counselled regarding outpatient management and instructed on postoperative care, follow-up appointments, and contact information. Telephone surveys of patients who underwent an outpatient laparoscopic appendectomy for uncomplicated appendicitis from January through October 2013 were performed. A Likert scale from very dissatisfied (1) to very satisfied (5) was employed. Patients were also queried that if, given the opportunity, they would have chosen to stay in the hospital.


RESULTS
Qualified patients included 41 men and 31 women with an average age of 36 years (range 19-79 years). Fifty-four (75%) were reached for satisfaction surveys. Patients were dismissed from the recovery room following a previously published protocol for outpatient management from 6 a.m. to noon (24%), noon to 6 p.m. (17%), 6 p.m. to midnight (22%), and midnight to 6 a.m. (37%). The average satisfaction score for outpatient management was 4.6 (range 2-5). Six patients (11%) stated that they would have preferred hospitalization, if given the opportunity. The reasons included inadequate pain control (2 patients); lack of home assistance (2 patients); nausea and vomiting (1 patient); and prolonged drowsiness (1 patient). Four of these patients violated the outpatient management guidelines (pain controlled on oral analgesics and adequate home assistance).


CONCLUSIONS
Outpatient laparoscopic appendectomy can be performed with high patient satisfaction, but adherence to protocol guidelines for outpatient management is important to properly select patients for outpatient management and to maximize patient satisfaction.
Baylor Scott & White Healthcare, Texas A&M Health Science Center , Temple, Texas.
Katherine A
KA
Anderson
Baylor Scott & White Healthcare, Texas A&M Health Science Center , Temple, Texas.
Stephen W
SW
Abernathy
Baylor Scott & White Healthcare, Texas A&M Health Science Center , Temple, Texas.
Daniel
D
Jupiter
Baylor Scott & White Healthcare, Texas A&M Health Science Center , Temple, Texas.
Richard C
RC
Frazee
D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000379:methods; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010149:Postoperative Pain / Q000628:therapy*; D017060:Patient Satisfaction; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy; D020250:Postoperative Nausea and Vomiting / Q000628:therapy*; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D055815:Young Adult
laparoscopy; outpatient appendectomy; patient satisfaction