Multivariate logistic model of hospital length of stay after appendectomy

Abstract

Background: Appendectomies are interesting because they are the most common emergency abdominal operations, they are considered simple procedures, and the imperative is a quick recovery measured by hospital length of stay (LOS). However, this is not always the case in clinical practice, hospitalization can be prolonged, and the question is what factors affect it. Methods: A multivariant logistic model of LOS predictors analyzed from the clinical data of 446 patients who underwent appendectomy at the Clinic for Emergency Surgery, Belgrade. The patients were divided into Short LOS group (SLOS hospital stay ≤3 days, 157 patients) and Long LOS group (LLOS hospital stay >3 days, 289 patients). Results: Significant differences were found between SLOS and LLOS groups in age (p<0.001), comorbidities (p=0.001), preoperative WBC (p = 0.004); preoperative CRP (p < 0.001); peritonitis (p < 0.001), using ≥ 2 antibiotics (p < 0.001), complicated appendicitis (p < 0.001), surgical time (P < 0.001). No significant difference was found concerning gender, postoperative WBC, CRP, and complications (p>0.05). Patients who underwent laparoscopic appendectomy (LAP) had a statistically significantly shorter hospitalization time compared to those who underwent Mini-Incision Open Appendectomy (MIOA) (p < 0.001). The multivariate logistic model found three statistically significant predictors of longer hospitalization: CRP preoperatively (B=0.006, p=0.047), OR=1.006, the type of surgery (B=1.199; p<0.001), OR=3.3 complicated appendicitis (B=0.762; p=0.003), OR=2.142. Conclusion: Surgical approach has statistically the most significant impact on LOS. Laparoscopic appendectomy is superior to Mini-Incision Open Appendectomy concerning the hospital LOS.