Christopher Pearcy, MD1, Theresa Jackson, MD2, Justin Regner, MD3, Dennis Kim, MD4, Lara Spence, MD4, Khalid Almahmoud, MD, MPH1, Vaidehi Agrawal, PhD1, Michael Truitt, MD1. 1Methodist Dallas Medical Center, 2University of Oklahoma – Tulsa, 3Baylor Scott and White, 4UCLA
Introduction: The current literature regarding outcomes in patients on irreversible antithrombotic (IAT) therapy undergoing urgent laparoscopic appendectomy is limited. The aim of this multicenter retrospective study was to describe the impact of prehospital IAT therapy on outcomes in this population.
Methods and Procedures: From 2010 to 2014, a three institution retrospective study was conducted to evaluate the clinical course of all patients who underwent urgent/emergent laparoscopic appendectomy. Two groups (IAT vs No IAT) were matched in a 1:1 ratio for age and gender. The primary outcomes were estimated blood loss (EBL) and transfusion requirement. Secondary outcomes included infections (SSI-surgical site, DSI-deep space infection and OSI-organ space infection), hospital length of stay (HLOS), complications, and mortality. A chi-square or Fisher’s exact test were employed for statistical significance in large or small sample sizes, respectively. A p ≤ 0.05 is considered statistically significant.
Results: 1510 patients were screened for the study. After 1:1 matching for age and gender, 195 IAT patients and 195 No IAT patients were identified. No significant differences in EBL (0.0999), transfusion requirement (0.1025 preoperative, 0.1573 intraoperative, 0.1025 postoperative), SSI (0.0833), DSI (0.1573), OSI (0.3173), overall complications (0.2253), HLOS (0.1441), or mortality (0.1573) were noted between the two groups. IAT patients were more likely to have at least one comorbid condition (<0.01, OR 23, CI 7.55 – 114. 25).
Conclusions: Our results demonstrate no difference in outcomes between the two groups. Emergent laparoscopic appendectomy is a safe procedure in patients on IAT therapy. Prehospital use of IAT therapy as an independent factor should not be used to delay laparoscopic appendectomy.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 80304
Program Number: S100
Presentation Session: Acute Care Surgery
Presentation Type: Podium