Retraso quirúrgico hospitalario de la apendicetomía y riesgo de complicaciones postoperatorias en apendicitis aguda complicada

Abstract

Determinar si en pacientes mayores de 18 años que son intervenidos quirúrgicamente por apendicitis aguda complicada, la incidencia de complicaciones post operatorias es mayor en aquellos que tienen un retraso quirúrgico hospitalario mayor a 8 horas que en aquellos menor o igual a 8 horas. Materiales y métodos: Se realizó un estudio observacional, de cohortes ambispectivas, se identificaron pacientes que fueron admitidos por apendicitis aguda complicada y fueron operados en el Hospital Regional Docente de Trujillo durante el periodo comprendido entre enero del 2019 y marzo del 2023; la muestra de cada cohorte fue de 182 pacientes. Resultados: La edad promedio fue 40,27 ± 17,87 vs 38,59 ± 15,74 en aquellos con tiempos quirúrgicos hospitalarios > y ≤ 8 horas; el 51,10% y 57,14% de los pacientes fueron varones en los grupos de estudio respectivamente. La incidencia de complicaciones postoperatorias global fueron 15,38% vs 3,85% (RR: 1,71 IC 95%: [1,40 – 2,09]); la incidencia de infección de sitio operatorio fue 7,69% vs 1,65% (RR: 1,70 IC 95% [1,33 – 2,17]); absceso intraabdominal 8,24% vs 1,65% (RR: 1,73 IC 95% [1,37 – 2,18]) y reintervención quirúrgica 10,99% vs 3,85% (1,54 IC 95% [1,20 – 1,98]) respectivamente. Conclusiones: El retraso quirúrgico hospitalario mayor a 8 horas estuvo asociado a un incremento en la incidencia de complicaciones postoperatorias de manera global y específica en pacientes operados por apendicitis aguda complicada.

To determine whether in patients older than 18 years who undergo surgery for complicated acute appendicitis, the incidence of postoperative complications is higher in those who have a hospital surgical delay of more than 8 hours than in those who have a delay of less than or equal to 8 hours. Materials and methods: An observational, ambispective cohort study was carried out, patients were identified who were admitted for complicated acute appendicitis and were operated on at the Hospital Regional Docente de Trujillo during the period between January 2019 and March 2023; the sample of each cohort was 182 patients. Results: mean age was 40.27 ± 17.87 vs 38.59 ± 15.74 in those with in-hospital surgical times > and ≤ 8 hours; 51.10% and 57.14% of patients were male in the study groups respectively. The incidence of overall postoperative complications were 15.38% vs 3.85% (RR: 1.71 95% CI: [1.40 - 2.09]); the incidence of operative site infection was 7.69% vs 1.65% (RR: 1.70 95% CI [1.33 - 2.17]); intra-abdominal abscess 8.24% vs 1.65% (RR: 1.73 95% CI [1.37 - 2.18]) and surgical reoperation 10.99% vs 3.85% (1.54 95% CI [1.20 - 1.98]) respectively. Conclusions: In-hospital surgical delay greater than 8 hours was associated with an increased incidence of postoperative complications globally and specifically in patients operated on for complicated acute appendicitis.