Computed tomography to operating room in less than 3 hours minimizes complications from appendicitis.
BACKGROUND
The aim of our study is to select patients with nonperforated appendicitis verified by computed tomography (CT) scan and to determine if there is a temporal component to perforation.


METHODS
A retrospective cohort study of patients with CT scan evidence of nonperforated appendicitis from 2007 to 2012.


RESULTS
411 patients, aged 39.7 ± 16.25 years (47.5% male) were included in the study. 330 patients (80.3%) were nonperforated at surgery. Analysis of 3-hour intervals from CT scan to operating room (OR) revealed an absolute reduction in the rate of perforation from 27% at the 6- to 9-hour interval, to 17% and 10% at the 3- to 6-hour and 0- to 3-hour intervals, respectively, (P < .04). All organ space infections occurred in patients who were delayed to the OR greater than 3 hours. Mean length of hospitalization was .93 days and 2.81 days, respectively, in nonperforated and perforated appendicitis patients (P < .001).


CONCLUSIONS
Delays to the OR were associated with increased risk of perforation. Patients with uncomplicated appendicitis had shorter hospitalization and fewer postoperative wound infections.
Department of Surgery, Scott and White Memorial Hospital, 2401 S 31st Street, 7th Floor Brindley Circles, Temple, TX 76508, USA.
Laura A
LA
Harmon
Department of Surgery, Scott and White Memorial Hospital, 2401 S 31st Street, 7th Floor Brindley Circles, Temple, TX 76508, USA.
Matthew L
ML
Davis
Department of Surgery, University of Texas Medical Branch, Galveston, TX, USA.
Daniel C
DC
Jupiter
Department of Surgery, Scott and White Memorial Hospital, 2401 S 31st Street, 7th Floor Brindley Circles, Temple, TX 76508, USA.
Richard C
RC
Frazee
Department of Surgery, Scott and White Memorial Hospital, 2401 S 31st Street, 7th Floor Brindley Circles, Temple, TX 76508, USA. Electronic address: Justin.Regner@BSWHealth.org.
Justin L
JL
Regner
D000328:Adult; D001062:Appendectomy; D001064:Appendicitis / Q000150:complications / Q000000981:diagnostic imaging* / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D012189:Retrospective Studies; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D055815:Young Adult
Appendicitis; CT scan; Complications; Timing