07). Figure 2c demonstrates that there was no difference in the overall length of stay (Mann-Whitney U test, p = 0.072), duration of delay to surgery (Mann-Whitney U test, p = 0.35) and length of postoperative stay in hospital (Mann-Whitney

U test, p = 0.25). Figure 2 Comparison of time from admission to surgery (a), postoperative length of stay (b) and total length of stay (c) between the two groups. Box and whisker graphs represent median ± inter-quartile range. Discussion Our audit in a comparable cohort of patients over two different time periods, after a change in theatre prioritisation policy, did not demonstrate any significant differences in the outcome after appendicectomy. The intention of implementing this change was to effectively reduce waiting times to emergency surgery and hence length of hospital stay – but clearly the present study has failed E7080 cell line to demonstrate this effect. There could be numerous reasons for this finding. Foremost, this could be due to the small sample size, which will require CP673451 cell line a multi-centre study.

Such a study could be hampered by AZD5582 mouse non-homogeneity of the profile of emergency workload. Our hospital is one of the premier trauma units in the UK and the only site of the only Helicopter emergency medical service (HEMS) in London. Despite this, numerically at least emergency general surgery accounts for 64.2% of all the emergency surgical workload with abscesses and acute appendicitis being the two most frequent reasons for requiring theatre [11]. Of course, trauma as well as vascular operations, because of the complexity of pre-operative and operative work and multiple team involvement, take longer duration and therefore occupy a prominent part of the emergency theatre schedule. Some authors have suggested an increase in post-appendicectomy complications and longer hospital stay associated to the delay to surgery [12, 13], whilst others have failed to demonstrate this trend [14–17]; although, LY294002 of course most patients would

prefer immediate surgical procedure [18]. In our cohort only four patients had a complication; of those, three were operated within 10 hours from admission and only one after 18 hours. Our data doesn’t demonstrate significant changes in outcome after the appendicectomy, despite changes in theatre prioritisation. The median length of hospital stay was 76 hours, comparable to other publications [13, 14]. Delay to surgery is associated with an increased incidence of complications and length of hospital stay after appendicectomy [12, 13, 19]. Analyzing a large series of 1081 patients, Ditillo et al[12] from the Yale University, USA demonstrated that in adult patients with acute appendicitis, the risk of developing advanced pathology and postoperative complications increases with time; particularly, those risks rise proportional to delay.