ArticleSurgical endoscopy2013
Thirty-day outcomes of laparoscopic versus open appendectomy in elderly using ACS/NSQIP database.
Article in Surgical endoscopy, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.
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Who cites it
12 citing papers in PubMed, 3 syntheses or guidelines pooled it, 34 citations in OpenAlex.
- EAES/SAGES evidence-based recommendations and expert consensus on optimization of perioperative care in older adults.Surgical endoscopy · 2024Guideline
- EAES rapid guideline: appendicitis in the elderly.Surgical endoscopy · 2021Guideline
- Laparoscopy versus open appendectomy for elderly patients, a meta-analysis and systematic review.BMC surgery · 2019Pooled it
- Risk factors for postoperative morbidity following appendectomy in the elderly: a nationwide prospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2021Article
- The use of emergency laparoscopy for acute abdomen in the elderly: the FRAILESEL Italian Multicenter Prospective Cohort Study.Updates in surgery · 2020Article
- Observational
- Do elderly patients have the most to gain from laparoscopic surgery?Annals of medicine and surgery (2012) · 2015Article
- Appendicitis in the modern era: universal problem and variable treatment.Surgical endoscopy · 2015Article
- Surgical site infection after laparoscopic and open appendectomy: a multicenter large consecutive cohort study.Surgical endoscopy · 2015Article
- Effect of hospital volume on outcomes of laparoscopic appendectomy for acute appendicitis: an observational study.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2015Observational
- Wound complications following laparoscopic surgery in a nigerian hospital.Nigerian journal of surgery : official publication of the Nigerian Surgical Research Society · 2014Article
- Acute appendicitis: position paper, WSES, 2013.World journal of emergency surgery : WJES · 2014Article
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Authors and funding
3 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundAlthough laparoscopic appendectomy is becoming the procedure of choice over open appendectomy in the treatment of appendicitis, its role in the elderly has not been widely studied. The objective of this study was to compare the 30-day outcomes after laparoscopic versus open for appendicitis in the elderly patients.
methodsUsing the American College of Surgeons National Surgical Quality Improvement Program (ACS/NSQIP) databases for years 2005-2009, 3,674 patients (age >65 years) who underwent an appendectomy for appendicitis were identified. Seventy-two percent of the procedures were performed laparoscopically. In addition to aggregate cohort analysis, propensity score 1:1 matching was used to minimize the treatment selection bias. The association between surgical approach and morbidity, mortality, and length of stay (LOS) were analyzed.
resultsIn the aggregate cohort analysis, patients who underwent an open appendectomy had a higher rate of minor morbidity (9.3% vs. 4.5%; p < 0.001), overall morbidity (13.4% vs. 8.2%, p < 0.001), and mortality (2% vs. 0.9%, p = 0.003). However, in the matched cohort analysis, open appendectomy was only associated with a higher rate of minor morbidity (9.3% vs. 5.7%; p = 0.002) and overall morbidity (13.4% vs. 10.1%; p = 0.02) but similar mortality rates (2% vs. 1.5%; p = 0.313). In matched cohort analysis, open appendectomy also was associated with a higher rate of superficial surgical site infection (SSI) (3.8% vs. 1.4%; p < 0.001) and a lower rate of organ/space SSI (1.3% vs. 2.9%; p = 0.009). Laparoscopic appendectomy was associated with a shorter LOS in both aggregate and matched cohorts compared with open appendectomy (p < 0.001).
conclusionsWithin ACS NSQIP hospitals, elderly patients benefited from a laparoscopic approach to appendicitis with regards to a shorter LOS and a lower minor and overall morbidity. Laparoscopic appendectomy was associated with lower superficial SSI and higher organ/space SSI rates.
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