Prolonged length of stay and many readmissions after appendectomy

INTRODUCTION: The epidemiology of appendicitis seems to be changing; the proportion of complicated appendicitis cases is growing. The outcome of childhood appendectomy in Denmark has not previously been evaluated nationwide in Denmark. MATERIAL AND METHODS: Data on all Danish children treated for appendicitis were obtained from the National Patient Registry. Re-operation, re-admittance or length of hospital stay (LOS) exceeding five days were considered non-satisfactory outcomes. RESULTS: A total of 2,617 children, 55% boys and 45% girls, were operated at 32 hospitals. Their mean age was 11.1 years. Mortality was 0%. A laparoscopic procedure was used in 34% of the cases. The medians of the postoperative LOS were one day for both the open and laparoscopic appendectomy groups, the corresponding means were 2.5 and 2.0 days (p < 0.05). 4.5% had one or more re-operations. 18% had a LOS > 5 days or re-admittance. The typical reasons were wound infection, need for prolonged antibiotics treatment and simple, prolonged recovery. CONCLUSION: The Danish practice for appendicitis has acceptable rates of re-operation, medians and means of LOS, and a rate of re-admission which is comparable to that reported in other studies. However, a non-satisfactory outcome after appendectomy in about 20% calls for improvement and further studies.