J. Tashiro1, E. A. Perez1, J. E. Sola1 1University Of Miami,Surgery,Miami, FL, USA
Introduction: We hypothesized that laparoscopic (LA) or open appendectomy (OA) outcomes are associated with weekend vs. weekday procedure date.
Methods: We queried the Kids’ Inpatient Database (1997-2012) for simple (540.9) and 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.
Results: Overall, 644,488 cases of simple and 147,952 cases of complicated appendicitis were identified.
On 1:1 propensity score (PS)-matched analyses of simple appendicitis, weekday OA had higher incision and drainage of wound (odds ratio: 2.2) and sepsis (odds ratio: 1.8) rates vs. weekend OA, p<0.04. Weekend OA had higher intraoperative perforation (1.9) and wound infection (1.5) rates and cost vs. weekday OA, p<0.02. Weekday LA had higher rates of wound infection (1.3) and pneumonia (1.4), but lower total charges (TC) vs. weekend LA, p<0.05.
For complicated appendicitis, weekday OA had increased wound infection rates (1.3) vs. weekend OA, p=0.003. Weekend OA had higher pneumonia rates (1.4) and longer LOS, but lower home healthcare requirement following discharge vs. weekday OA, p<0.05. Weekend LA had higher TC vs. weekday LA, p<0.001.
Conclusion: On a PS-matched comparison of appendectomies performed for simple and complicated appendicitis on weekends and weekdays, procedure day is associated with different complication rates and resource utilization for OA and LA.