The impact of regional reconfiguration on the management of appendicitis

Hdl Handle:
http://hdl.handle.net/10147/302990
Title:
The impact of regional reconfiguration on the management of appendicitis
Authors:
Healy, D. A.; McCartan, D. P.; Grace, P. A.; Aziz, A.; Dermody, F.; Clarke Moloney, M.; Coffey, J. C.; Walsh, S. R.; Burke, P. E.
Citation:
The impact of regional reconfiguration on the management of appendicitis 2013 Irish Journal of Medical Science
Publisher:
Irish Journal of Medical Science
Journal:
Irish Journal of Medical Science
Issue Date:
Oct-2013
URI:
http://hdl.handle.net/10147/302990
DOI:
10.1007/s11845-013-1015-x
Additional Links:
http://link.springer.com/10.1007/s11845-013-1015-x
Abstract:
Background Reconfiguration of surgical services in the Mid-West in 2009 resulted in a large increase in numbers of patients undergoing emergency surgery for appendicitis in University Hospital Limerick (UHL). Aims The aim of this study was to assess the impact of reconfiguration on the management of appendicitis in this area. Methods Data on all patients who underwent appendicectomy between January and June 2007 were compared with the corresponding data from January to June 2011. The numbers of operations, types of operations, lengths of stay (LOS), operation start times, rates of negative histology specimens and readmissions within 30 days were compared. One hundred and twenty-five appendicectomies [48 laparoscopic (38.4 %)] were performed in the 2007 group of which 32 specimens (25.6 %) were histologically negative. Three hundred and nineteen appendicectomies [238 laparoscopic (74.6 %)] were performed in the 2011 group of which 62 specimens (19.4 %) were histologically negative. The increase in numbers of laparoscopic procedures was significant (p < 0.001). The reduction in the negative appendicectomy rate was not statistically significant (p = 0.16). There were 10 conversions (20.8 %) to open surgery in the 2007 period and 12 (5 %) in the 2011 period (p = 0.001). Mean LOS for the 2007 and 2011 groups was 4.45 and 3.16 days (p < 0.001). Six (4.8 %) readmissions within 30 days occurred in the 2007 group with 20 (6.3 %) in the 2011 group (p = 0.66). Conclusion Though reconfiguration of surgical services has resulted in a significant increase in workload, LOS has decreased significantly while maintaining acceptably low negative appendicectomy, conversion and readmission rates.
Item Type:
Article
Language:
en
Keywords:
HEALTH SERVICES AND THEIR MANAGEMENT; SURGERY
ISSN:
0021-1265; 1863-4362

Full metadata record

DC FieldValue Language
dc.contributor.authorHealy, D. A.en_GB
dc.contributor.authorMcCartan, D. P.en_GB
dc.contributor.authorGrace, P. A.en_GB
dc.contributor.authorAziz, A.en_GB
dc.contributor.authorDermody, F.en_GB
dc.contributor.authorClarke Moloney, M.en_GB
dc.contributor.authorCoffey, J. C.en_GB
dc.contributor.authorWalsh, S. R.en_GB
dc.contributor.authorBurke, P. E.en_GB
dc.date.accessioned2013-10-08T15:29:02Z-
dc.date.available2013-10-08T15:29:02Z-
dc.date.issued2013-10-
dc.identifier.citationThe impact of regional reconfiguration on the management of appendicitis 2013 Irish Journal of Medical Scienceen_GB
dc.identifier.issn0021-1265-
dc.identifier.issn1863-4362-
dc.identifier.doi10.1007/s11845-013-1015-x-
dc.identifier.urihttp://hdl.handle.net/10147/302990-
dc.description.abstractBackground Reconfiguration of surgical services in the Mid-West in 2009 resulted in a large increase in numbers of patients undergoing emergency surgery for appendicitis in University Hospital Limerick (UHL). Aims The aim of this study was to assess the impact of reconfiguration on the management of appendicitis in this area. Methods Data on all patients who underwent appendicectomy between January and June 2007 were compared with the corresponding data from January to June 2011. The numbers of operations, types of operations, lengths of stay (LOS), operation start times, rates of negative histology specimens and readmissions within 30 days were compared. One hundred and twenty-five appendicectomies [48 laparoscopic (38.4 %)] were performed in the 2007 group of which 32 specimens (25.6 %) were histologically negative. Three hundred and nineteen appendicectomies [238 laparoscopic (74.6 %)] were performed in the 2011 group of which 62 specimens (19.4 %) were histologically negative. The increase in numbers of laparoscopic procedures was significant (p < 0.001). The reduction in the negative appendicectomy rate was not statistically significant (p = 0.16). There were 10 conversions (20.8 %) to open surgery in the 2007 period and 12 (5 %) in the 2011 period (p = 0.001). Mean LOS for the 2007 and 2011 groups was 4.45 and 3.16 days (p < 0.001). Six (4.8 %) readmissions within 30 days occurred in the 2007 group with 20 (6.3 %) in the 2011 group (p = 0.66). Conclusion Though reconfiguration of surgical services has resulted in a significant increase in workload, LOS has decreased significantly while maintaining acceptably low negative appendicectomy, conversion and readmission rates.en_GB
dc.language.isoenen
dc.publisherIrish Journal of Medical Scienceen_GB
dc.relation.urlhttp://link.springer.com/10.1007/s11845-013-1015-xen_GB
dc.rightsArchived with thanks to Irish Journal of Medical Scienceen_GB
dc.subjectHEALTH SERVICES AND THEIR MANAGEMENTen_GB
dc.subjectSURGERYen_GB
dc.titleThe impact of regional reconfiguration on the management of appendicitisen_GB
dc.typeArticleen
dc.identifier.journalIrish Journal of Medical Scienceen_GB
dc.description.fundingNo fundingen
dc.description.provinceMunsteren
dc.description.peer-reviewpeer-reviewen
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