TY  - JOUR
T1  - Routine same-day discharge after acute or interval appendectomy in children: A prospective study
AU  - Alkhoury F, Malvezzi L, Knight CG, et al
Y1  - 2012/05/01
N1  - 10.1001/archsurg.2012.132
JO  - Archives of Surgery
SP  - 443
EP  - 446
VL  - 147
IS  - 5
N2  - Hypothesis 
                  The outcomes of and parental satisfaction with same-day discharge in children undergoing laparoscopic appendectomy warrant making it the usual and customary pathway.Design 
                  Prospective cohort study.Setting 
                  Tertiary care children's hospital.Patients 
                  Between July 1, 2010, and March 30, 2011, a total of 207 children were considered for same-day discharge after acute or interval laparoscopic appendectomy. The all-in-one single-incision single-instrument technique was used in 95.7% of children.Interventions 
                  Same-day discharge vs overnight admission.Main Outcome Measures 
                  Operative details, postoperative length of stay, adverse events, and parental satisfaction.Results 
                  Of 207 consecutive children undergoing acute (n = 186) or interval (n = 21) appendectomy, 162 (78.3%) were discharged on the day of surgery. The remaining 45 children were admitted overnight because the hour was too late for discharge in 35 (77.8%), medical indications dictated admission in 5 (11.1%), and social reasons required admission in 5 (11.1%). In all the children, oral medication alone was used for postoperative pain. The complication rates were similar in the same-day discharge group (8.0%) and in the admitted group (6.6%), as were the rates of urgent postoperative visits (7.4% vs 4.4%%) and the readmission rates (2.5% vs 2.2%) (P > .05 for all). The same-day discharge group had a reduced postoperative length of stay compared with the admitted group (mean, 5 vs 16 hours, P < .05). At the time of discharge, most parents (87.0%) stated they were happy with the expeditious discharge, whereas 8.0% indicated they felt nervous but were ultimately satisfied. In retrospect, 8 of 162 parents (4.9%) were not sure early discharge was best, but only 1 parent would insist on admission if faced with the situation again.Conclusion 
                  Routine same-day discharge after pediatric appendectomy seems safe, with good parental satisfaction.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.2012.132
UR  - http://dx.doi.org/10.1001/archsurg.2012.132
ER  -