Trì hoãn từ chỉ định mổ đến phẫu thuật và tình trạng viêm ruột thừa có biến chứng khi mổ

Abstract

Delayed appendectomy during overnight emergency shifts at a tertiary hospital is often unavoidable, but the safety of short delay after the decision to operate remains uncertain. This retrospective cohort study included adults aged 18 years or older with CT-diagnosed acute appendicitis who underwent appendectomy during the index admission. The primary analysis was restricted to patients without CT signs of complicated disease. Exposure was the decision-to-incision interval categorized as < 6 hours vs ≥ 6 hours. The primary outcome was operative/pathology-confirmed complicated appendicitis. Of 496 source patients, 358 were included in the primary cohort. The complication rate was 30.3% in the < 6-hour group and 28.1% in the ≥ 6-hour group. Delay of 6 hours or more was not clearly associated with increased risk in robust modified Poisson regression (clinical + CT adjusted RR = 1.11; 95% CI: 0.80 - 1.56). Findings were consistent across sensitivity analyses. In adults with CT-uncomplicated appendicitis, short organizational delay after the decision to operate was not clearly associated with a higher risk of complicated appendicitis.