J Korean Soc Coloproctol.  1998 Sep;14(3):561-568.

Impact of Physician Delay on Postoperative Outcome of Patients with Acute Appendicitis

• Cho BW
• Park SH
• Yoon SG
• Choi KW

Abstract

BACKGROUND: It is controversial whether the delay of surgery for acute appendicitis by physician results in higher morbidity. Our present study explores this problem of physician delay on the postoperative outcome of patients with acute appendicitis. MATERIAL AND METHODS: Among 432 patients admitted for the presumptive diagnosis of acute appendicitis between Jan., 1995 and Dec., 1997, 358 patients with pathologically proven acute appendicits were analyzed. Physician delay from the hospital admission to the surgery was evaluated in relation to the stage of the disease at operation and postoperative outcome.
RESULTS
Postoperative complications occurred signifficantly higher in advanced appendicitis group, than in simple appendicitis group. Postoperative oral consumption started significantly later and hospital days are significantly prolonged in those group. Both patient and physician delays significantly affect the stage of the disease. The finding that physician delay correlated with the stage, however, was denied by multivariate analysis.
CONCLUSION
On the contrary to the patient delay, physician delay does not affect the stage of the acute appendicitis nor lead to increased incidence of postoperative complication. Physician delay to clarify the diagnosis is a reasonable strategy and it does not affect the outcome adversely.

Keyword

Physician delay; Acute appendicitis

MeSH Terms

Appendicitis*
Diagnosis
Humans
Incidence
Multivariate Analysis
Postoperative Complications