Homeward bound: the safety of discharging postappendectomy patients directly home from the recovery room

Abstract

The discharge of the patients directly from the recovery room after appendectomy has only recently been described in the literature. Because the 30-day readmission rate is used as a surrogate for safety and as a means to identify complications from appendicitis, it is our aim to demonstrate that the 30-day readmission rate of patients with acute appendicitis discharged from the recovery room is not higher than that of a control group and that from other studies in the literature for traditional hospital discharge. The operating room electronic database at Kaiser Riverside and Kaiser Moreno Valley hospitals was used to identify all appendectomies from September 1, 2008, to April 30, 2013. During that span, 2044 appendectomies were performed. Eight hundred seventy (43%) were discharged from the recovery room. Of these patients, 861 (99%) had a laparoscopic appendectomy. The average time from anesthesia end time until discharge from the recovery room was 2 hours 42 minutes. There were 12 (1.4%) total readmissions with nine (1%) related to previous appendectomy compared with one (0.9%) in the control group. None of the readmissions were the result of early life-threatening problems such as bleeding, bowel injury, intraperitoneal bladder injury, or stump leak. Patients with acute appendicitis who were discharged home from the recovery room did not have an increased incidence of 30-day readmission when compared with traditional hospital discharge.