Z. Al-Qurayshi1, E. Kandil1 1Tulane University School Of Medicine,Surgery,New Orleans, LA, USA
Introduction: Time from hospital admission to surgery has been suggested to be a crucial risk factor. In this study, we aim to compare the outcomes of one day delayed surgeries to those done on the same day of admission in patients presented with perforated bowel.
Methods: Time from hospital admission to surgery has been suggested to be a crucial risk factor. In this study, we aim to compare the outcomes of one day delayed surgeries to those done on the same day of admission in patients presented with perforated bowel.
Results: 7,415 discharge records were included. 1,753 (23.5%) patients had delayed intervention, while (76.5%) patients had operation on the same admission date. Next day interventions were more likely to be associated with postoperative complications [OR: 1.24, 95%CI (1.08, 1.41), p=0.002]. However by considering complications types individually; pulmonary complications were higher for next day operations (p<0.01), while same day operation had higher risk of wound complications (p<0.01). Patients who had next day surgery were at risk of a hospital stay of more than 14 days (p<0.001). Hospital located in the Northern region of the United States were more likely to delay the intervention until the next day of admission compared to rest of United States( p<0.001). Additionally, women were at higher risk of next day operation compared to men (p=0.01). The average cost of health services for next day operation was significantly higher compared to same day operation ($33,146.00± 907.96 vs. $ 28,658.00± 414.33, p<0.001).
Conclusion: Delaying surgical intervention for patients presented with perforated bowels is associated with disadvantageous outcomes. Gender and geographical disparities associated with the time of intervention.