The effect of diabetes on outcomes following emergency appendectomy in patients without comorbidities: a propensity score-matched analysis of National Surgical Quality Improvement Program database

Abstract

Background: The effect of diabetes and the role of laparoscopic surgery on outcomes following appendectomy for acute appendicitis are not known.

Methods: National Surgical Quality Improvement Program study, including patients with acute appendicitis and no significant comorbidities (American Society of Anesthesiologists grade I or II) who underwent appendectomy. Diabetic patients were matched (1:3) with nondiabetic patients. The primary outcomes were 30-day mortality, surgical site infections (SSIs), and systemic infectious complications.

Results: SSI was encountered more frequently in the diabetic group as compared with the nondiabetic group (6.1% vs 4.3%, P = .010). Also, the hospital length of stay was significantly longer in the diabetic group. In the diabetic group, laparoscopic appendectomy did not affect mortality, reoperation, SSI, and systemic infectious complication rates in patients with or without peritonitis (P > .05), but the hospital length of stay was significantly shorter when compared with the open procedure.

Conclusions: Patients with diabetes and no significant comorbidities have a higher risk of developing SSIs and longer hospital stay than patients without diabetes. Laparoscopic appendectomy had no effect on SSIs in patients with diabetes.

Keywords: Acute appendicitis; Diabetes; No comorbid conditions; Outcomes.