Lane Rebecca S, Tashiro Jun, Burroway Brandon W, Perez Eduardo A, Sola Juan E
Division of Pediatric Surgery, DeWitt-Daughtry Family Department of Surgery, Leonard M. Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 450K, Miami, FL, 33136, USA.
Pediatr Surg Int. 2018 Jun;34(6):621-628. doi: 10.1007/s00383-018-4260-2. Epub 2018 Apr 6.
We hypothesized that laparoscopic (LA) or open appendectomy (OA) outcomes in complicated appendicitis are associated with weekend vs. weekday procedure date.
We queried the Kids' Inpatient Database (1997-2012) for complicated (540.0, 540.1) appendicitis treated with LA or OA. Propensity score (PS)-matched analysis compared outcomes associated with weekend vs. weekday LA and OA.
Overall, 103,501 cases of complicated appendicitis were identified. On 1:1 PS-matched analyses of complicated appendicitis, weekday OA had increased wound infection rates (odds ratio: 1.3) vs. weekend OA, p < 0.001. Weekend OA had higher pneumonia rates (1.4) and longer length of stay, but lower home healthcare requirement following discharge vs. weekday OA, p < 0.05. Weekend and weekday LA had no significant outcome differences.
On a PS-matched comparison of appendectomies performed for complicated appendicitis on weekends and weekdays, procedure day is associated with different complication rates and resource utilization for OA. For LA, no weekend effect was noted for complicated appendicitis. To ensure the optimal patient care, prospective studies should be sought to identify causes of complications dependent on the day of procedure.
我们推测，复杂阑尾炎的腹腔镜（LA）或开腹阑尾切除术（OA）的结果与手术日期是周末还是工作日有关。
我们在儿童住院数据库（1997 - 2012年）中查询接受LA或OA治疗的复杂（540.0、540.1）阑尾炎病例。倾向评分（PS）匹配分析比较了与周末和工作日LA及OA相关的结果。
总体上，共识别出103,501例复杂阑尾炎病例。在对复杂阑尾炎进行1:1 PS匹配分析时，与周末OA相比，工作日OA的伤口感染率增加（优势比：1.3），p < 0.001。与工作日OA相比，周末OA的肺炎发生率更高（1.4），住院时间更长，但出院后家庭医疗护理需求更低，p < 0.05。周末和工作日LA的结果无显著差异。
在对周末和工作日进行复杂阑尾炎阑尾切除术的PS匹配比较中，手术日期与OA的不同并发症发生率和资源利用情况相关。对于LA，复杂阑尾炎未发现周末效应。为确保最佳患者护理，应开展前瞻性研究以确定取决于手术日期的并发症原因。
