The impact of delayed surgical intervention in complicated appendicitis: A retrospective study

Abstract

Background: Complex appendicitis, which includes perforation, abscess formation, or peritonitis, is associated with substantial clinical difficulties that carry a higher risk of morbidity and mortality with delayed surgical intervention. Optimal timing for surgical intervention, following initial treatment has been debated in the field of emergency surgery. Objective: To identify the effects of delayed surgical intervention on patient outcomes with complicated appendicitis including length of stay, complications and mortality. Methods: This study was designed as a retrospective cohort study to identify the impact of delays in surgical intervention, or delayed timing, in those patients diagnosed with complicated appendicitis at a private hospital in Baghdad from January 2020 to December 2023. A total of 342 patients were identified for the cohort study and each was classified into either characteristics of medical and surgical intervention within 6 hours of diagnosis (early intervention) or > 6 hours from diagnosis (delayed intervention). Primary outcomes of the study were length of stay, any post-operative complications and 30-day mortality. Secondary outcomes included indwelling or surgical site infections, 30 day hospital re-admission and costs to the healthcare system. Results: Of 342 patients, 198 (57.9%) entered into the early intervention group and 144 (42.1%) entered into the delayed intervention group. Length of hospital stay was significantly longer (8.3±3.2 vs 5.8±2.4 days, p