Computed tomography to operating room in less than 3 hours minimizes complications from appendicitis

Background: The aim of our study is to select patients with nonperforated appendicitis verified by computed tomography (CT) scan and to determine if there is a temporal component to perforation. Methods: A retrospective cohort study of patients with CT scan evidence of nonperforated appendicitis from 2007 to 2012. Results: 411 patients, aged 39.7 ± 16.25 years (47.5% male) were included in the study. 330 patients (80.3%) were nonperforated at surgery. Analysis of 3-hour intervals from CT scan to operating room (OR) revealed an absolute reduction in the rate of perforation from 27% at the 6- to 9-hour interval, to 17% and 10% at the 3- to 6-hour and 0- to 3-hour intervals, respectively, (P <.04). All organ space infections occurred in patients who were delayed to the OR greater than 3 hours. Mean length of hospitalization was .93 days and 2.81 days, respectively, in nonperforated and perforated appendicitis patients (P <.001). Conclusions: Delays to the OR were associated with increased risk of perforation. Patients with uncomplicated appendicitis had shorter hospitalization and fewer postoperative wound infections.