Clinical ScienceComputed tomography to operating room in less than 3 hours minimizes complications from appendicitis

- Retrospective review of nonperforated appendicitis diagnosed on initial CT scan.
- Evaluated patients from time of CT scan to time to the OR in 3-hour intervals.
- Higher rates of perforation were associated with delays to OR greater than 3 hours.
- Higher rate of complications were observed in patients with perforation.

BackgroundThe aim of our study is to select patients with nonperforated appendicitis verified by computed tomography (CT) scan and to determine if there is a temporal component to perforation.MethodsA retrospective cohort study of patients with CT scan evidence of nonperforated appendicitis from 2007 to 2012.Results411 patients, aged 39.7 ± 16.25 years (47.5% male) were included in the study. 330 patients (80.3%) were nonperforated at surgery. Analysis of 3-hour intervals from CT scan to operating room (OR) revealed an absolute reduction in the rate of perforation from 27% at the 6- to 9-hour interval, to 17% and 10% at the 3- to 6-hour and 0- to 3-hour intervals, respectively, (P < .04). All organ space infections occurred in patients who were delayed to the OR greater than 3 hours. Mean length of hospitalization was .93 days and 2.81 days, respectively, in nonperforated and perforated appendicitis patients (P < .001).ConclusionsDelays to the OR were associated with increased risk of perforation. Patients with uncomplicated appendicitis had shorter hospitalization and fewer postoperative wound infections.