OBJECTIVES: To investigate the association between time to appendectomy and the risk of surgical site infections (SSIs) in @entity1 with @entity698 across multiple NSQIP-Pediatrics institutions. BACKGROUND: Several recently published single institution retrospective studies have reported conflicting relationships between delaying appendectomy and the risk of increasing surgical site infections (SSI) in both @entity1 and adults. This study combines data from NSQIP-Pediatrics with institutional data to perform a multi-institutional analysis to examine the effects of delaying appendectomy on surgical site infections. METHODS: Data from NSQIP-Pediatrics between January 2010 and June 2012 for cases of appendectomy for @entity698 at 6 institutions (preoperative characteristics, time of operation, and postoperative occurrences) were combined with data from medical record review (length of symptoms; times of initial presentation, @entity341 ( @entity341 ) triage, and admission; and diagnosis as @entity698 ( @entity698 , acute) or @entity532 ( @entity532 , gangrenous/ruptured)). Cochran-Armitage tests for trend and multivariable logistic regression models were used to evaluate associations between time to appendectomy and SSI. RESULTS: Of the 1338 @entity1 included, 70% had @entity698 and 30% had @entity532 . Postoperative SSIs were more common in @entity532 (5.7% vs 1.2%, P<0.001). SSI rates did not differ significantly across hospitals (P=0.17). Compared with @entity1 who did not develop an SSI, @entity1 who developed an SSI had similar times between @entity341 triage and appendectomy (median (interquartile range) 11.5hours (6.4-14.7) versus 9.7hours (5.8-15.6, P=0.36), and similar times from admission to appendectomy (5.5hours (1.9-10.2) versus 4.3hours (1.4-9.9), P=0.36). Independent risk factors for SSI were @entity532 (Odds Ratio (95% CI): 3.46 (1.48-8.10), P=0.004), longer symptom duration (OR for a 10-hour increase: 1.05 (1.01-1.10), P=0.02), and presence of @entity295 / @entity326 (2.70 (1.17-6.28), P=0.02). CONCLUSIONS: A 16-hour delay from @entity341 presentation or a 12-hour delay from hospital admission to appendectomy was not associated with an increased risk for SSI.

Delaying Appendectomy Does Not Lead to Higher Rates of Surgical Site Infections: A Multi-institutional Analysis of @entity1 With XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'patients'] @entity295 :: ('MESH:D018805', 'Disease') :: ['sepsis'] @entity698 :: ('MESH:D001064', 'Disease') :: ['appendicitis', 'SA', 'simple appendicitis'] @entity326 :: ('MESH:D012772', 'Disease') :: ['septic shock'] @entity341 :: ('MESH:D004630', 'Disease') :: ['emergency department', 'ED'] @entity532 :: ('MESH:D003925', 'Disease') :: ['CA', 'complicated appendicitis']
@entity698 :: (MESH:D001064,Disease) :: ['Appendicitis']
