title: [Management of acute appendicitis : Evidence for prompt surgical treatment?]
abstract: BACKGROUND
  Acute appendicitis is a common disease which requires immediate surgical treatment of the focus of inflammation. So far there are no reliable data on how much time can pass between hospitalization, indications for surgery and initiating surgery without an increased risk of morbidity and mortality for the patient.
  
  
  OBJECTIVE
  The aim of this study was to investigate how much time can lapse between admission and initiation of surgery for acute appendicitis while still providing patient safety and no increase in complication rates.
  
  
  METHODS
  This retrospective analysis investigated the management of all patients who underwent appendectomy under the suspicion of acute appendicitis. Besides the time span between hospital admittance and beginning of the operation (admission to incision time, AIT), anamnestic, diagnostic, technical and perioperative data were assessed and statistically analyzed (mean ± SD).
  
  
  RESULTS
  From January 2008 to April 2013 a total of 655 patients underwent appendectomy. The mean AIT was 7 h and the rate of negative appendectomy was 9.8 %. The mean hospitalization period was 5.9 ± 8.7 days with a postoperative stay of 5.2 ± 7.1 days. A comparison of the subgroups stratified by increasing AIT showed that there was no increased probability for perforation or postoperative complications with an AIT of up to 8 h.
  
  
  CONCLUSIONS
  This retrospective cohort study showed that appendectomy should be performed within the first 8 h after hospitalization of the patient.
authors: Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland. j.slotta@kkh-geriatrie-igb.de.|Klinik für Allgemein- und Viszeralchirurgie, Kreiskrankenhaus St. Ingbert GmbH, Klaus-Tussing-Straße 1, 66386, St. Ingbert, Deutschland. j.slotta@kkh-geriatrie-igb.de.
authors: J E
authors: JE
authors: Slotta
authors: Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
authors: U
authors: U
authors: Kopsch
authors: Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.
authors: M
authors: M
authors: Ghadimi
authors: Klinik für Allgemein-, Viszeral- und Kinderchirurgie, Universitätsmedizin Göttingen, Robert-Koch-Str. 40, 37075, Göttingen, Deutschland.|Klinik für Allgemein- und Viszeralchirurgie, HELIOS Dr. Horst Schmidt Kliniken, Ludwig-Erhard-Straße 100, 65199, Wiesbaden, Deutschland.
authors: O
authors: O
authors: Kollmar
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000379:methods*; D001064:Appendicitis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D019317:Evidence-Based Medicine; D005260:Female; D005858:Germany; D006801:Humans; D007223:Infant; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
keywords: Acute appendicitis; Admittance to incision time; Complication; Perforation; Surgical management