Risk Factors Influencing Discharge in Patients Undergoing Daytime Laparoscopic Appendectomy.

Abstract

Objective: This study examined the preoperative factors influencing the discharge of patients undergoing laparoscopic appendectomy and examined the impact of intraoperative and postoperative recovery on discharge.

Methods: We performed a retrospective analysis of clinical data from 158 patients who underwent laparoscopic appendectomy after admission to the emergency day-surgery ward of our hospital from January to December 2022. The patients were categorized into two groups based on the length of stay: the daytime group (length of stay ≤48 hours) and the routine group (length of stay >48 hours). We compared the effects of preoperative assessments, intraoperative variables, and postoperative outcomes on the discharge of the patients between the two groups.

Results: Preoperative analysis of general data revealed that the time to discharge of patients undergoing daytime laparoscopic appendectomy (P < .05) were significantly influenced age; leukocyte, monocyte, neutrophil, and lymphocyte counts; systemic inflammation response index (SIRI); and appendix diameter. Multivariate logistic regression analysis identified appendix diameter (P = .017), SIRI (P = .024), and white blood cell count (P = .037) as independent risk factors affecting postoperative discharge in patients after daytime laparoscopic appendectomy. Receiver operating characteristic (ROC) curve analysis revealed that SIRI (ROC: 0.876; cutoff: 4.74), white blood cell count (ROC: 0.692; cutoff: 11.995), and appendix diameter (ROC: 0.760; cutoff: 9.5) could predict short-term hospital discharge, with SIRI exhibiting the highest predictive value. Intraoperative operation times, placement of drainage tubes, and pathological type also significantly influenced the discharge time (P < .05).

Conclusion: : SIRI, white blood cell count, and appendix diameter are key factors influencing the discharge of patients undergoing emergency day-surgery appendicitis.