TPW 1.11 Does Timing Matter? Time to Surgery from Diagnosis and its Effect on Outcomes in Acute Appendicitis

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ID: 324020
2026
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Abstract
Abstract Aim Surgical intervention remains the definitive treatment for acute appendicitis and can be time critical. This study assesses whether delays in surgery contributed to increased rates of appendiceal perforation in adult patients and impacts on hospital stay. Methods Data were retrospectively collected from electronic records for all consecutive appendicectomies performed between 2021 and 2024. Patient demographics, CT findings, intraoperative findings, time from presentation to surgery (TTS), and length of stay (LOS) were analysed. Independent t-tests and chi-square tests were used, with p < 0.05 considered statistically significant. Results Out of 189 appendicectomies, CT showed perforated-appendicitis in 81 (42.9%) and non-perforated in 108 (57.1%); however, 50 of the “non-perforated” cases had perforation noted intraoperatively. Time to surgery (TTS) was slightly longer in the perforated group (20.92 vs 19.88 hours; p=0.047), and logistic regression showed each additional hour of delay increased the odds of perforation by 4.2% (p=0.015). In subgroup analysis, median TTS was 16.3 hours (max 79 hours). Readmissions occurred in 5 (10%) perforated cases due to postoperative collection, small bowel obstruction, and stump appendicitis. Perforation was associated with a significantly longer length of stay: median 4 days versus the typical 1 day for uncomplicated non-perforated cases (p<0.001). Conclusion Surgery remains the mainstay of appendicitis treatment. Delays beyond 24 hours increase morbidity and length of stay. Time to theatre is a critical factor in emergency surgical admissions and directly affects patient care. Even without mortality or major morbidity, timely surgery improves overall patient experience, especially in challenging healthcare settings.
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Authors Olufemi Oduneye, Shashikanth Vijayaraghavalu, Sithdharthan Ravikumar, Aravindan Narayanan, Shuker Yahia
Journal the british journal of surgery
Year 2026
DOI
10.1093/bjs/znag087.295
URL
https://doi.org/10.1093/bjs/znag087.295
Keywords Keywords not found

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