Risk Factors Influencing Discharge in Patients Undergoing Daytime Laparoscopic Appendectomy.

OBJECTIVE

This study examined the preoperative factors influencing the discharge of patients undergoing laparoscopic appendectomy and examined the impact of intraoperative and postoperative recovery on discharge.

METHODS

We performed a retrospective analysis of clinical data from 158 patients who underwent laparoscopic appendectomy after admission to the emergency day-surgery ward of our hospital from January to December 2022. The patients were categorized into two groups based on the length of stay: the daytime group (length of stay ≤48 hours) and the routine group (length of stay >48 hours). We compared the effects of preoperative assessments, intraoperative variables, and postoperative outcomes on the discharge of the patients between the two groups.

RESULTS

Preoperative analysis of general data revealed that the time to discharge of patients undergoing daytime laparoscopic appendectomy ( < .05) were significantly influenced age; leukocyte, monocyte, neutrophil, and lymphocyte counts; systemic inflammation response index (SIRI); and appendix diameter. Multivariate logistic regression analysis identified appendix diameter ( = .017), SIRI ( = .024), and white blood cell count ( = .037) as independent risk factors affecting postoperative discharge in patients after daytime laparoscopic appendectomy. Receiver operating characteristic (ROC) curve analysis revealed that SIRI (ROC: 0.876; cutoff: 4.74), white blood cell count (ROC: 0.692; cutoff: 11.995), and appendix diameter (ROC: 0.760; cutoff: 9.5) could predict short-term hospital discharge, with SIRI exhibiting the highest predictive value. Intraoperative operation times, placement of drainage tubes, and pathological type also significantly influenced the discharge time ( < .05).

CONCLUSION

SIRI, white blood cell count, and appendix diameter are key factors influencing the discharge of patients undergoing emergency day-surgery appendicitis.