Surgical Timeliness in Acute Appendicitis: Evaluating Systemic and Demographic Factors Affecting Time to Theatre

Abstract

Aims
International guidelines advocate for timely appendectomy, within 24 hours of diagnosis of acute uncomplicated appendicitis. The aim of this study was to determine institutional compliance with these guidelines and to establish the impact of demographic and admission factors on time to theatre (TTT) and length of stay (LOS).

Methods
A retrospective analysis was conducted on 183 patients who underwent appendectomy for acute appendicitis over a 12-month period in 2023. Data collected included age, sex, day of admission, TTT, and LOS.

Results
183 patients were included in the final analysis, with a mean age of 35.7 years (SD 14.8). Median TTT was 13.0 hours (IQR 16.6), and was within guideline 24 hours for the majority of patients (152, 83.1%). Median LOS was 2.0 days, and was unaffected by TTT.

Discussion
TTT was within international guidelines for the majority of patients. No significant associations were identified between TTT and patient demographics or admission factors, suggesting that systemic factors underpin access to timely surgical care. The absence of correlation between TTT and LOS further supports the safety of short and clinically managed delays.