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Delay in wait time for appendectomy does not increase risk of death or complications: study

Toronto, September 21, 2010

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.

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.”

Appendectomy is one of the most common surgical procedures performed worldwide and accounts for an estimated 25,000 hospital stays in Canada each year. While it is expected that disease severity and complications would increase the longer a patient waits to have an appendectomy, the study found patient outcomes were not affected.

About 75 per cent of patients had their operations within six hours of admission, 15 per cent within six and 12 hrs and 10 per cent after 12 hours. The time to complete the operation was similar, yet those who had their operations beyond 12 hours had a slightly longer length of hospital stay after their surgery — 1.8 days for those operated on within 12 hours and 2.2 days if operated on later, a difference in length of stay not felt to be clinically important.

About St. Michael’s

St. Michael’s Hospital provides compassionate care to all who walk through its doors. The Hospital also provides outstanding medical education to future health care professionals in more than 23 academic disciplines. Critical care and trauma, heart disease, neurosurgery, diabetes, cancer care, and care of the homeless are among the Hospital’s recognized areas of expertise. Through the Keenan Research Centre and the Li Ka Shing Knowledge Institute, research at St. Michael’s Hospital is recognized and put into practice around the world. Founded in 1892, the Hospital is fully affiliated with the University of Toronto.

Media Contacts

For more information, please contact:

Julie Saccone
Senior Public Relations Specialist
St. Michael's Hospital
416-864-5047
sacconej@smh.ca