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المؤلفون: Bas P. L. Wijnhoven, Anne Loes van den Boom, Elisabeth M. L. de Wijkerslooth, Jay M. Bakas, Joost van Rosmalen
المساهمون: Surgery, Epidemiology
المصدر: International Journal of Colorectal Disease
International Journal of Colorectal Disease, 36(6), 1297-1309. Springer-Verlagمصطلحات موضوعية: medicine.medical_specialty, 030230 surgery, Patient Readmission, 03 medical and health sciences, 0302 clinical medicine, Patient satisfaction, Appendectomy, Humans, Medicine, Same day discharge, Hospital readmission, business.industry, Gastroenterology, Appendicitis, Same-day discharge, medicine.disease, Patient Discharge, 030220 oncology & carcinogenesis, Meta-analysis, Relative risk, Acute appendicitis, Emergency medicine, Length of stay, Original Article, Laparoscopy, Complication, business, Readmission
الوصف: Purpose Patients presenting with acute appendicitis are usually hospitalized for a few days for appendectomy and postoperative recovery. Shortening length of stay may reduce costs and improve patient satisfaction. The purpose of this study was to assess the safety of same-day discharge after appendectomy for acute appendicitis. Methods A systematic review was performed according to PRISMA guidelines. A literature search of EMBASE, Ovid MEDLINE, Web of Science, Cochrane Central, and Google Scholar was conducted from inception to April 14, 2020. Two reviewers independently screened the literature and selected studies that addressed discharge on the same calendar day as the appendectomy. Risk of bias was assessed with the ROBINS-I tool. Main outcomes were hospital readmission, complications, and unplanned hospital visits in the postoperative course. A random effects model was used to pool risk ratios for the main outcomes. Results Of the 1912 articles screened, 17 comparative studies and 8 non-comparative studies met the inclusion criteria. Most only included laparoscopic procedure for uncomplicated appendicitis. Most studies were considered at moderate or serious risk of bias. In meta-analysis, same-day discharge (vs. overnight hospitalization) was not associated with increased rates of readmission, complication, and unplanned hospital visits. Non-comparative studies demonstrated low rates of readmission, complications, and unplanned hospital visits after same-day discharge. Conclusion This study suggests that same-day discharge after laparoscopic appendectomy for uncomplicated appendicitis is safe without an increased risk of readmission, complications, or unplanned hospital visits. Hence, same-day discharge may be further encouraged in selected patients. Trial registration PROSPERO registration no. CRD42018115948
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