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Patients can wait for appendectomy: study

Delaying surgery to remove an appendix by 12 hours or more does not lead to increased complications or a greater risk of death after 30 days, according to a study led by St. Michael’s hospital trauma surgeon Dr. Avery Nathens.

Toronto, October 8, 2010

Dr. Avery Nathens Dr. Avery Nathens

The study, published today in the Archives of Surgery (JAMA), studied data from 32,782 patients who underwent an appendectomy, a surgical procedure to remove an appendix, between 2005 to 2008.

“Our study found no significant differences in complications or deaths among patients who had an appendectomy within six hours, between six to 12 hours and after more than 12 hours of being admitted to hospital,” said Dr. Nathens, senior author and division head of general surgery and director of trauma at St. Michael’s. “These findings will help health-care organizations and physicians better allocate their emergency care resources for those patients in most need.”

Medical needs of patients continue to grow as the population ages and demands for access to emergency care and specialist coverage increase, the study’s authors note. As care needs become increasingly complex, physical and professional resources are stretched. Consequently, acute care surgeons may need to delay the operations of less critically ill patients such as those requiring an appendectomy to care for those who require immediate attention.

“We have shown that these operations are safely postponed to the light of day,” Dr. Nathens said. “The challenge now is to ensure that patients with conditions like appendicitis have the opportunity to receive the care they require at a time of day traditionally dominated by elective surgery, like cancer operations and hip replacements.”