Outpatient management of uncomplicated appendicitis. A Cohort study
Luna Guerrero CE, Oropeza Duarte C, Suárez Velázquez DL, Buenrostro Espinosa R, Almada Manzo D, Martínez Gómez YS, García Morán K, García Colunga MF, Torres Salazar QL. Outpatient management of uncomplicated appendicitis. A Cohort study. Am J Med Surg.
BACKGROUND. Acute appendicitis is the most frequent cause of emergency surgery, and it is estimated that 5-20% of the population will suffer from it at some point. Outpatient appendectomy can be performed in selected cases without increasing the incidence of complications and also reducing the costs involved. Objective: To know the safety and cost / effectiveness of outpatient management from postoperative appendectomy patients in uncomplicated appendicitis cases. Material and methods: An observational, analytical study of a prospective cohort, carried out at the Hospital General Regional No 1 IMSS Obregón, Sonora. Postoperative patients with appendectomy, secondary to uncomplicated acute appendicitis, were included. The safeness of outpatient management was analyzed, using the presence or absence of complications as an indicator. Likewise, a cost / effectiveness estimate of the outpatient procedure was made. Results: A total of 63 appendectomies were performed; 22 with outpatient management (34%) and 41 with conventional management (66%). There were no differences in the frequency of complications (p = 0.57); the variable that represented the greatest risk for complications was the body mass index RR 1.24 (0.22 - 6). The savings for the institute according to outpatient management is $15,533 Mexican pesos, per patient. Conclusions: There is no difference in the complications' presence in outpatient management of appendectomy secondary to uncomplicated appendicitis compared to conventional management, so it is considered a secure strategy. The decrease in the length of hospital stay, in addition to being a cost / effective procedure, has an impact on reducing the probability of nosocomial infection.
KEY WORDS: Acute appendicitis, outpatient management.