SynthesisJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2019
Effect of Delay to Operation on Outcomes in Patients with Acute Appendicitis: a Systematic Review and Meta-analysis.
Synthesis in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 4 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 4 syntheses or guidelines pooled it, 58 citations in OpenAlex.
- Daytime versus nighttime appendectomy in term of complications and clinical outcomes: a meta-analysis.International journal of colorectal disease · 2024Pooled it
- The impact of timing on outcomes in appendicectomy: a systematic review and network meta-analysis.World journal of emergency surgery : WJES · 2024Pooled it
- Spontaneous Resolution of Uncomplicated Appendicitis may Explain Increase in Proportion of Complicated Appendicitis During Covid-19 Pandemic: a Systematic Review and Meta-analysis.World journal of surgery · 2023Pooled it
- Acute Appendicitis in Childhood and Adulthood.Deutsches Arzteblatt international · 2020Pooled it
- Article
- Development and validation of a diagnostic nomogram based on peripheral blood composite inflammatory markers for complicated acute appendicitis: a retrospective study.Frontiers in surgery · 2026Article
- Impact of preoperative delay on perforation in pediatric appendicitis.Frontiers in pediatrics · 2026Article
- Appendicitis.Nature reviews. Disease primers · 2025Review
- Gola Khisakna as a Culture-bound Syndrome: A Case Series from India.Indian journal of psychological medicine · 2025Article
- Surgical delay in appendicitis among children: the role of social vulnerability.Frontiers in pediatrics · 2025Article
- Barriers to accessing appendectomy in the public sector health system in the Western Cape Province, South Africa.African journal of emergency medicine : Revue africaine de la medecine d'urgence · 2024Article
- Navigating appendicitis care during the Covid-19 pandemic: a retrospective cohort study in China.BMC surgery · 2024Article
- Can Physicians Delay Appendectomy for One Night in Children With Acute Appendicitis?Middle East journal of digestive diseases · 2024Article
- Associations between Hospital Setting and Outcomes after Pediatric Appendectomy.Children (Basel, Switzerland) · 2023Article
- Factors Contributing to Delays to Accessing Appendectomy in Low- and Middle-Income Countries: A Scoping Review.World journal of surgery · 2023Article
- Is acute appendicitis more severe in foreign workers of northern Israel? A retrospective cohort study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Risk factors for postoperative morbidity, prolonged length of stay and hospital readmission after appendectomy for acute appendicitis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Clinical Outcomes of Daytime Versus Nighttime Laparoscopic Appendectomy in Children.Children (Basel, Switzerland) · 2023Article
- Variations in clinical course and surgical outcomes of acute appendicitis during COVID-19 Pandemic: a multicenter cohort study.BMC surgery · 2023Article
- Clinical Experience of Emergency Appendectomy under the COVID-19 Pandemic in a Single Institution in South Korea.Medicina (Kaunas, Lithuania) · 2022Article
Corrections and comments
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Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMany studies have investigated the association between time interval and incidence of complicated appendicitis and post-operative surgical site infection (SSI), but the results are controversial.
methodsA systematic search of the electronic databases identified studies that investigated the association of appendectomy delay with complicated appendicitis and SSI among patients with acute appendicitis. Qualitative and quantitative meta-analysis of the results was conducted.
resultsTwenty-one studies were included in the final analysis. Meta-analysis showed no significant difference in complicated appendicitis incidence between patients in the 6-12 h, > 12 and < 6 h groups (OR 1.07, 95% CI 0.89-1.30, p = 0.47; OR 1.04, 95% CI 0.88-1.22, p = 0.64). Comparison of the 6-12 h category with the < 6 h category of in-hospital delay revealed significant associations between longer in-hospital delay and increased risk of post-operative SSI (OR 1.40, 95% CI 1.11-1.77, p = 0.004). Patients in the 24-48 h category had 1.99- and 1.84-fold (p < 0.05) higher odds of developing complicated appendicitis compared to patients in the < 24 h category for pre-hospital delay and total delay, respectively (OR 1.99, 95% CI 1.35-2.94, p = 0.0006; OR 1.84, 95% CI 1.05-3.21, p = 0.03). When pre-hospital and total delay time extended to more than 48 h, the odds of risk increased 4.62- and 7.57-fold, respectively (OR 4.62, 95% CI 2.99-7.13, p < 0.00001; OR 7.57, 95% CI 6.14-9.35, p = < 0.00001).
conclusionComplicated appendicitis incidence was associated with overall elapsed time from symptom onset to admission or operation; short appendectomy in-hospital delay did not increase the risk of complicated appendicitis but was associated with a slightly increased risk of SSI. Prompt surgical intervention is warranted to avoid additional morbidity, enabling quicker recovery in this population.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.