Treatment of acute appendicitis in France by type of hospital: Patient profiles are different but practices and results are the same, a prospective cohort study of 1241 patients - 03/12/21
for the
APPEA Project Group1
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Abstract |
Background |
In this prospective observational study we compared patient characteristics, surgical practices and results, according to the type of hospital to which patients with acute appendicitis were admitted.
Methods |
We extracted data concerning all adults in the French Surgical Association's Multicenter register of patients admitted to emergency or surgical units for acute appendicitis (APPEA) over 4 months in 2016.
Results |
The APPEA database included 1241 adults. 806 patients (64.9%) were admitted to a University Hospital (UH), 337 (27.2%) to a Regional Hospital (RH) and 98 (7.9%) to Private Clinics (PC). RH admitted significantly older patients (median age 35 [25–53], p=.008) and a higher percentage of obese patients (55 (17.9%) p< .001) than UH (median age 30 [23–45], BMI ≥30: 54 (8.4%)) and PC (median age 33.5 [24–54], BMI ≥30: 9 (10.7%)). Only 17 (1.4%) patients underwent surgery without any preoperative imaging examination. Laparoscopy was significantly more frequent in PC (94.9%) and UH (94.2%) than in RH (86.9%) (p ≤ 0.001). Thirty-day overall mortality (0.24%)) and morbidity (8.2%) were not significantly related to the type of hospital. The median length of hospital stay was longer in RH than in UH: 69 h [45–106] vs 48 [24–96] respectively, (p ≤ 0.001).
Conclusion |
We observed a significant difference in the characteristics of patients operated on for appendicitis between different types of hospital, and some low inhomogeneity of practices. Nevertheless results in terms of morbi-mortality were comparable with a low rate of morbimortality, allowing future higher proportion of outpatient procedures regardless of the type of hospital.
Le texte complet de cet article est disponible en PDF.Key words : Appendicitis, Appendectomy, Surgical practices
Plan
| Data sharing: Data described in the manuscript, code file, and analytic code will be made available upon reasonable request. |
Vol 4
Article 100028- décembre 2021 Retour au numéro
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