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Optimal Time to Surgery for Patients Requiring Laparoscopic Appendectomy: An Integrative Review
Author(s) -
Gardiner Therese M.,
Gillespie Brigid M.
Publication year - 2016
Publication title -
aorn journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.222
H-Index - 43
eISSN - 1878-0369
pISSN - 0001-2092
DOI - 10.1016/j.aorn.2015.12.006
Subject(s) - medicine , presentation (obstetrics) , general surgery , emergency surgery , appendicitis , acute appendicitis , surgery , intervention (counseling) , nursing
Acute appendicitis is the most common condition requiring emergency surgery worldwide. Although current guidelines recommend prompt appendectomy as the preferred treatment, no time interval for surgery has been indicated. We used an integrative review methodology to critically evaluate evidence on the relationship between time to surgery and hospital length of stay and to identify the ideal time to surgery for patients undergoing appendectomy. We included 14 studies in our synthesis, most of which (n = 9/14, 64%) indicated that longer time delays to surgical intervention increased hospital length of stay for patients presenting with appendicitis. Researchers report that the optimal time for surgery is 24 to 36 hours after symptom onset, or 10 to 24 hours from admission. The results of our review indicate that patient symptoms on presentation may signify advancing pathology and may be more important than the time delay interval in defining surgical priority.