Surgical outcomes researchLaparoscopic appendectomy in the elderly☆
Section snippets
Study population and description of databases
Data for patients with International Classification of Diseases, revision 9 (ICD-9), procedure codes for LA (47.01) or OA (47.09) were selected from the 1998, 1999, and 2000 Nationwide Inpatient Samples (NIS).11., 12., 13. Patient data with primary diagnosis codes other than appendicitis and with any procedure code of incidental appendectomy were excluded from our analysis (Appendix I). The NIS are among the largest publicly available in-patient databases in the United States. The 1998, 1999,
Results
Our database contained information about 148,660 patients who underwent LA or OA. After the exclusion of patients with a diagnosis of appendicolithiasis and appendicopathia oxyurica (n = 2659) and patients who underwent incidental appendectomies (n = 711), 145,290 patients remained in our analyses: 32,406 patients (22.3%) underwent LA; 112,884 patients (77.7%) underwent OA; 9476 patients (6.5%) were equal to 65 years of age and older; 135,814 patients (93.5%) were less than 65 years of age.
In both
Discussion
This is the first investigation based on data from large nationwide databases that assess important end points in both patients less than 65 years old and elderly patients who have undergone LA and OA for appendicitis. The findings of the present investigation confirm our previous results for the overall patient population, with LA having significant advantages over OA in terms of mean length of hospital stay (LA, 2.45 days; OA, 3.71; P<.0001), rate of routine discharge (OR, 2.80; 95% CI [2.43,
Acknowledgements
We thank the Division of Orthopedic Surgery, Duke University Medical Center, Durham, NC, for providing the 1998, 1999, and 2000 Nationwide Inpatient Samples.
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Supported in part by the Swiss National Foundation, Bern/Switzerland, Krebsliga beider Basel, Basel/Switzerland, Freiwillige Akademische Gesellschaft, Basel/Switzerland, and Fondazione Gustav e Ruth Jacob, Aranno/Switzerland (U.G.).