Is it safe? Appendectomies at night at a low-volume center.

OBJECTIVE

Recent literature reports an increased risk of morbidity and mortality in nonemergency operations performed during nonregular duty hours at large institutions. Of the nonemergency operations performed after regular duty hours, appendectomies remain the most common. The study seeks to answer the question as to whether it is safe to continue performing appendectomies during non-normal duty hours at a low-volume institution.

DESIGN

The study is a retrospective cohort review examining 102 appendectomies for suspected appendicitis over a 46-month period from July 2005 to May 2010. The total number of cases, gender, type of procedure, start and stop time, and complications were recorded and analyzed.

SETTING

Keesler Medical Center, located on Keesler Air Force Base, Mississippi.

PARTICIPANTS

All patients with appendectomies for presumed appendicitis observed between July 2005 and May 2010.

RESULTS

No statistical difference was found between complication rates during off-duty hours and normal duty hours at our institution (p = 0.619; odds ratio = 0.34722, 95% confidence interval = 0.035-2.45).

CONCLUSIONS

Performing appendectomies after regular-duty hours at our institution does not increase the risk of mortality and morbidity.