The influence of age, duration of symptoms and duration of operation on outcome after appendicitis in children.

INTRODUCTION The aim of the study was to evaluate the impact of any perioperative parameters on the outcome of treatment for appendicitis. MATERIAL AND METHODS The study included 108 consecutive children with appendicitis. Data were retrieved from files using the codes for appendectomy of the Nordic Classification of Surgical Procedures and the diagnosis codes for appendicitis from the International Classification of Dis-eases (ICD) 10. A non-satisfactory outcome was defined as a post-operative length of stay in hospital ≥ 5 days and/or readmission due to complications. RESULTS Significantly more patients with a non-satisfactory outcome had complicated appendicitis (73%) compared with those with a satisfactory outcome (25%). A total of 78% of children < 6 years and 44% of children > 10 years had a non-satisfactory outcome. The duration of symptoms before operation was mean 2.8 days for children with a non-satisfactory outcome and 2.7 days for those with complicated appendicitis compared with 1.5 days for children with a satisfactory outcome and 1.6 days for those with simple appendicitis. The median difference was two days in the younger patients. Surgical time was significantly shorter in the group of patients with a satisfactory outcome and in those with simple appendicitis than in the other groups. CONCLUSION Complicated appendicitis and a non-satisfactory outcome in children after operation are associated with a long preoperative duration of symptoms, young age and long surgical time. A cut-off age has not been established, but young children might benefit from direct referral and access to hospitalization in a regional or tertiary paediatric surgical centre. FUNDING not relevant. TRIAL REGISTRATION not relevant.