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The literature has reported that fast track surgery can be safely applied to children undergoing appendectomy for acute appendicitis. There is no current evidence regarding the application of same day discharge protocol in children with intra-operative findings of suppurative appendicitis. The current standard of care for patients who present with intra-operative findings of suppurative appendicitis includes post-operative admission and treatment with intravenous antibiotics. Patients are discharged home once they have met the following discharge criteria: temperature less than 38.5 degrees Celsius, pain control with oral pain medication, and tolerating a liquid diet. Given the evidence in the literature that has shown that same day discharge of patients with acute appendicitis is safe and effective, we propose that fast track surgery protocol can be safely applied to patients with intraoperative findings of suppurative appendicitis. We hypothesize that this will result in a decreased postoperative length of stay, without an increase in 30-day complication rate.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Fast track | Experimental | Patients discharged home the same day following appendectomy |
|
| Admission | No Intervention | Patients are admitted to the inpatient unit following appendectomy for suppurative appendicitis and treated per the current standard of care. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Patients discharged home the same day following appendectomy | Other | Patients are discharged to home on the same day following appendectomy with oral antibiotics. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Post Operative Length of Stay | Post anesthesia care unit arrival to discharge home, an expected average of up to 48 hours |
| Measure | Description | Time Frame |
|---|---|---|
| Thirty Day Complication Rate | Superficial wound infection, deep organ space infection, ileus or bowel obstruction requiring hospitalization or re-operation | Thirty days |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Nicole M Chandler, MD | Johns Hopkins All Children's Hospital | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Johns Hopkins All Children's Hospital | St. Petersburg | Florida | 33701 | United States |
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| ID | Title | Description |
|---|---|---|
| FG000 | Fast Track | Patients discharged home the same day following appendectomy Patients discharged home the same day following appendectomy: Patients are discharged to home on the same day following appendectomy with oral antibiotics. |
| FG001 | Admission | Patients are admitted to the inpatient unit following appendectomy for suppurative appendicitis and treated per the current standard of care. |
| Title | Milestones | Reasons Not Completed | ||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Overall Study |
|
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| ID | Title | Description |
|---|---|---|
| BG000 | Fast Track | Patients discharged home the same day following appendectomy Patients discharged home the same day following appendectomy: Patients are discharged to home on the same day following appendectomy with oral antibiotics. |
| BG001 | Admission |
| Units | Counts |
|---|---|
| Participants |
|
| Title | Description | Population Description | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Denominator Units Selected | Denominators | Classes |
|---|---|---|---|---|---|---|---|---|---|
| Age, Categorical | Count of Participants |
| Type | Title | Description | Population Description | Reporting Status | Anticipated Posting Date | Parameter Type | Dispersion Type | Unit of Measure | Calculate Percentage | Time Frame | Units Analyzed | Denominator Units Selected | Arm/Group Information | Denominators | Classes | Analyses | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Primary | Post Operative Length of Stay | Posted | Mean | Standard Deviation | Hours | Post anesthesia care unit arrival to discharge home, an expected average of up to 48 hours |
|
Thirty days
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| ID | Title | Description | Deaths (Affected) | Deaths (At Risk) | Serious Events (Affected) | Serious Events (At Risk) | Other Events (Affected) | Other Events (At Risk) |
|---|---|---|---|---|---|---|---|---|
| EG000 | Fast Track | Patients discharged home the same day following appendectomy Patients discharged home the same day following appendectomy: Patients are discharged to home on the same day following appendectomy with oral antibiotics. |
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The small number of patients enrolled in each arm and the low number of 30-day patient follow up limit the interpretation of the current results.
| Title | Organization | Phone | Extension | |
|---|---|---|---|---|
| Dr. Nicole Chandler | All Children's Hospital Johns Hopkins Medicine | 727-767-4170 | Nicole.Chandler@jhmi.edu |
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| ID | Term |
|---|---|
| D001064 | Appendicitis |
| ID | Term |
|---|---|
| D059413 | Intraabdominal Infections |
| D007239 | Infections |
| D005759 | Gastroenteritis |
| D005767 | Gastrointestinal Diseases |
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Patients are admitted to the inpatient unit following appendectomy for suppurative appendicitis and treated per the current standard of care. |
| BG002 | Total | Total of all reporting groups |
| Participants |
|
| Age, Continuous | Mean | Standard Deviation | years |
|
| Sex: Female, Male | Count of Participants | Participants |
|
| Region of Enrollment | Number | participants |
|
| Units | Counts |
|---|
| Participants |
|
|
| Secondary | Thirty Day Complication Rate | Superficial wound infection, deep organ space infection, ileus or bowel obstruction requiring hospitalization or re-operation | Posted | Number | participants | Thirty days |
|
|
|
| 0 |
| 18 |
| 0 |
| 18 |
| EG001 | Admission | Patients are admitted to the inpatient unit following appendectomy for suppurative appendicitis and treated per the current standard of care. | 0 | 18 | 0 | 18 |
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| D004066 |
| Digestive System Diseases |
| D002429 | Cecal Diseases |
| D007410 | Intestinal Diseases |