Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study
Abstract Laparoscopic appendectomy (LA) for treatment of acute appendicitis has gained acceptance with its considerable benefits over open appendectomy. LA, however, can involve some adverse outcomes: morbidity, prolonged length of hospital stay (LOS) and hospital readmission. Identification of pred...
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Nature Portfolio
2019
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oai:doaj.org-article:e19e3362a47a4617901cc6db34e773ae2021-12-02T16:08:43ZRisk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study10.1038/s41598-019-51172-22045-2322https://doaj.org/article/e19e3362a47a4617901cc6db34e773ae2019-10-01T00:00:00Zhttps://doi.org/10.1038/s41598-019-51172-2https://doaj.org/toc/2045-2322Abstract Laparoscopic appendectomy (LA) for treatment of acute appendicitis has gained acceptance with its considerable benefits over open appendectomy. LA, however, can involve some adverse outcomes: morbidity, prolonged length of hospital stay (LOS) and hospital readmission. Identification of predictive factors may help to identify and tailor treatment for patients with higher risk of these adverse events. Our aim was to identify risk factors for serious morbidity, prolonged LOS and hospital readmission after LA. A database compiled information of patients admitted for acute appendicitis from eighteen Polish and German surgical centers. It included factors related to the patient characteristics, peri- and postoperative period. Univariate and multivariate logistic regression models were used to identify risk factors for serious perioperative complications, prolonged LOS, and hospital readmissions in acute appendicitis cases. 4618 laparoscopic appendectomy patients were included. First, although several risk factors for serious perioperative complications (C-D III-V) were found in the univariate analysis, in the multivariate model only the presence of intraoperative adverse events (OR 4.09, 95% CI 1.32–12.65, p = 0.014) and complicated appendicitis (OR 3.63, 95% CI 1.74–7.61, p = 0.001) was statistically significant. Second, prolonged LOS was associated with the presence of complicated appendicitis (OR 2.8, 95% CI: 1.53–5.12, p = 0.001), postoperative morbidity (OR 5.01, 95% CI: 2.33–10.75, p < 0.001), conversions (OR 6.48, 95% CI: 3.48–12.08, p < 0.001) and reinterventions after primary procedure (OR 8.79, 95% CI: 3.2–24.14, p < 0.001) in the multivariate model. Third, although several risk factors for hospital readmissions were found in univariate analysis, in the multivariate model only the presence of postoperative complications (OR 10.33, 95% CI: 4.27–25.00), reintervention after primary procedure (OR 5.62, 95% CI: 2.17–14.54), and LA performed by resident (OR 1.96, 95% CI: 1.03–3.70) remained significant. Laparoscopic appendectomy is a safe procedure associated with low rates of complications, prolonged LOS, and readmissions. Risk factors for these adverse events include complicated appendicitis, postoperative morbidity, conversion, and re-intervention after the primary procedure. Any occurrence of these factors during treatment should alert the healthcare team to identify the patients that require more customized treatment to minimize the risk for adverse outcomes.Maciej WalędziakAnna LasekMichał WysockiMichael SuMaciej BobowiczPiotr MyśliwiecKamil AstapczykMateusz BurdzelKarolina ChruścielRafał CyganWojciech CzubekNatalia Dowgiałło-WnukiewiczJakub DrośPaula FranczakWacław HołówkoArtur KacprzykWojciech Konrad KarczJakub KenigPaweł KonradArkadiusz KopiejćAdam KotKarolina KrakowskaMaciej KuklaAgnieszka LeszkoLeszek ŁozowskiPiotr MajorWojciech MakarewiczPaulina Malinowska-TorbiczMaciej MatyjaMaciej MichalikAdam NiekurzakDamian NowińskiRadomir OstaszewskiMałgorzata PabisMałgorzata Polańska-PłachtaMateusz RubinkiewiczTomasz StefuraAnna StępieńPaweł SzabatRafał ŚmiechowskiSebastian TomaszewskiViktor von Ehrlich-TreuenstättMaciej WasilczukMateusz WierdakAnna WojdyłaJan Wojciech WrońskiLeszek ZwolakiewiczMichał PędziwiatrNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 9, Iss 1, Pp 1-9 (2019) |
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DOAJ |
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Medicine R Science Q |
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Medicine R Science Q Maciej Walędziak Anna Lasek Michał Wysocki Michael Su Maciej Bobowicz Piotr Myśliwiec Kamil Astapczyk Mateusz Burdzel Karolina Chruściel Rafał Cygan Wojciech Czubek Natalia Dowgiałło-Wnukiewicz Jakub Droś Paula Franczak Wacław Hołówko Artur Kacprzyk Wojciech Konrad Karcz Jakub Kenig Paweł Konrad Arkadiusz Kopiejć Adam Kot Karolina Krakowska Maciej Kukla Agnieszka Leszko Leszek Łozowski Piotr Major Wojciech Makarewicz Paulina Malinowska-Torbicz Maciej Matyja Maciej Michalik Adam Niekurzak Damian Nowiński Radomir Ostaszewski Małgorzata Pabis Małgorzata Polańska-Płachta Mateusz Rubinkiewicz Tomasz Stefura Anna Stępień Paweł Szabat Rafał Śmiechowski Sebastian Tomaszewski Viktor von Ehrlich-Treuenstätt Maciej Wasilczuk Mateusz Wierdak Anna Wojdyła Jan Wojciech Wroński Leszek Zwolakiewicz Michał Pędziwiatr Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study |
| description |
Abstract Laparoscopic appendectomy (LA) for treatment of acute appendicitis has gained acceptance with its considerable benefits over open appendectomy. LA, however, can involve some adverse outcomes: morbidity, prolonged length of hospital stay (LOS) and hospital readmission. Identification of predictive factors may help to identify and tailor treatment for patients with higher risk of these adverse events. Our aim was to identify risk factors for serious morbidity, prolonged LOS and hospital readmission after LA. A database compiled information of patients admitted for acute appendicitis from eighteen Polish and German surgical centers. It included factors related to the patient characteristics, peri- and postoperative period. Univariate and multivariate logistic regression models were used to identify risk factors for serious perioperative complications, prolonged LOS, and hospital readmissions in acute appendicitis cases. 4618 laparoscopic appendectomy patients were included. First, although several risk factors for serious perioperative complications (C-D III-V) were found in the univariate analysis, in the multivariate model only the presence of intraoperative adverse events (OR 4.09, 95% CI 1.32–12.65, p = 0.014) and complicated appendicitis (OR 3.63, 95% CI 1.74–7.61, p = 0.001) was statistically significant. Second, prolonged LOS was associated with the presence of complicated appendicitis (OR 2.8, 95% CI: 1.53–5.12, p = 0.001), postoperative morbidity (OR 5.01, 95% CI: 2.33–10.75, p < 0.001), conversions (OR 6.48, 95% CI: 3.48–12.08, p < 0.001) and reinterventions after primary procedure (OR 8.79, 95% CI: 3.2–24.14, p < 0.001) in the multivariate model. Third, although several risk factors for hospital readmissions were found in univariate analysis, in the multivariate model only the presence of postoperative complications (OR 10.33, 95% CI: 4.27–25.00), reintervention after primary procedure (OR 5.62, 95% CI: 2.17–14.54), and LA performed by resident (OR 1.96, 95% CI: 1.03–3.70) remained significant. Laparoscopic appendectomy is a safe procedure associated with low rates of complications, prolonged LOS, and readmissions. Risk factors for these adverse events include complicated appendicitis, postoperative morbidity, conversion, and re-intervention after the primary procedure. Any occurrence of these factors during treatment should alert the healthcare team to identify the patients that require more customized treatment to minimize the risk for adverse outcomes. |
| format |
article |
| author |
Maciej Walędziak Anna Lasek Michał Wysocki Michael Su Maciej Bobowicz Piotr Myśliwiec Kamil Astapczyk Mateusz Burdzel Karolina Chruściel Rafał Cygan Wojciech Czubek Natalia Dowgiałło-Wnukiewicz Jakub Droś Paula Franczak Wacław Hołówko Artur Kacprzyk Wojciech Konrad Karcz Jakub Kenig Paweł Konrad Arkadiusz Kopiejć Adam Kot Karolina Krakowska Maciej Kukla Agnieszka Leszko Leszek Łozowski Piotr Major Wojciech Makarewicz Paulina Malinowska-Torbicz Maciej Matyja Maciej Michalik Adam Niekurzak Damian Nowiński Radomir Ostaszewski Małgorzata Pabis Małgorzata Polańska-Płachta Mateusz Rubinkiewicz Tomasz Stefura Anna Stępień Paweł Szabat Rafał Śmiechowski Sebastian Tomaszewski Viktor von Ehrlich-Treuenstätt Maciej Wasilczuk Mateusz Wierdak Anna Wojdyła Jan Wojciech Wroński Leszek Zwolakiewicz Michał Pędziwiatr |
| author_facet |
Maciej Walędziak Anna Lasek Michał Wysocki Michael Su Maciej Bobowicz Piotr Myśliwiec Kamil Astapczyk Mateusz Burdzel Karolina Chruściel Rafał Cygan Wojciech Czubek Natalia Dowgiałło-Wnukiewicz Jakub Droś Paula Franczak Wacław Hołówko Artur Kacprzyk Wojciech Konrad Karcz Jakub Kenig Paweł Konrad Arkadiusz Kopiejć Adam Kot Karolina Krakowska Maciej Kukla Agnieszka Leszko Leszek Łozowski Piotr Major Wojciech Makarewicz Paulina Malinowska-Torbicz Maciej Matyja Maciej Michalik Adam Niekurzak Damian Nowiński Radomir Ostaszewski Małgorzata Pabis Małgorzata Polańska-Płachta Mateusz Rubinkiewicz Tomasz Stefura Anna Stępień Paweł Szabat Rafał Śmiechowski Sebastian Tomaszewski Viktor von Ehrlich-Treuenstätt Maciej Wasilczuk Mateusz Wierdak Anna Wojdyła Jan Wojciech Wroński Leszek Zwolakiewicz Michał Pędziwiatr |
| author_sort |
Maciej Walędziak |
| title |
Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study |
| title_short |
Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study |
| title_full |
Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study |
| title_fullStr |
Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study |
| title_full_unstemmed |
Risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from Pol-LA (Polish Laparoscopic Appendectomy) multicenter large cohort study |
| title_sort |
risk factors for serious morbidity, prolonged length of stay and hospital readmission after laparoscopic appendectomy - results from pol-la (polish laparoscopic appendectomy) multicenter large cohort study |
| publisher |
Nature Portfolio |
| publishDate |
2019 |
| url |
https://doaj.org/article/e19e3362a47a4617901cc6db34e773ae |
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