ArticleIrish journal of medical science2014
The impact of regional reconfiguration on the management of appendicitis.
Article in Irish journal of medical science, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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Who cites it
3 citing papers in PubMed.
- Regional consolidation of orthopedic surgery: impacts on hip fracture surgery access and outcomes.Canadian journal of surgery. Journal canadien de chirurgie · 2017Article
- Magnitude of non-operative surgical emergency admissions; service implications for surgical and radiological practice.Irish journal of medical science · 2017Article
- On-table urethral catheterisation during laparoscopic appendicectomy: Is it necessary?Canadian Urological Association journal = Journal de l'Association des urologues du CanadaArticle
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Authors and funding
9 authors.
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Abstract
backgroundReconfiguration of surgical services in the Mid-West in 2009 resulted in a large increase in numbers of patients undergoing emergency surgery for appendicitis in University Hospital Limerick (UHL).
aimsThe aim of this study was to assess the impact of reconfiguration on the management of appendicitis in this area.
methodsData on all patients who underwent appendicectomy between January and June 2007 were compared with the corresponding data from January to June 2011. The numbers of operations, types of operations, lengths of stay (LOS), operation start times, rates of negative histology specimens and readmissions within 30 days were compared. One hundred and twenty-five appendicectomies [48 laparoscopic (38.4 %)] were performed in the 2007 group of which 32 specimens (25.6 %) were histologically negative. Three hundred and nineteen appendicectomies [238 laparoscopic (74.6 %)] were performed in the 2011 group of which 62 specimens (19.4 %) were histologically negative. The increase in numbers of laparoscopic procedures was significant (p < 0.001). The reduction in the negative appendicectomy rate was not statistically significant (p = 0.16). There were 10 conversions (20.8 %) to open surgery in the 2007 period and 12 (5 %) in the 2011 period (p = 0.001). Mean LOS for the 2007 and 2011 groups was 4.45 and 3.16 days (p < 0.001). Six (4.8 %) readmissions within 30 days occurred in the 2007 group with 20 (6.3 %) in the 2011 group (p = 0.66).
conclusionThough reconfiguration of surgical services has resulted in a significant increase in workload, LOS has decreased significantly while maintaining acceptably low negative appendicectomy, conversion and readmission rates.
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