Time to appendectomy for acute appendicitis: A systematic review

Danielle B. Cameron, Regan Williams*, Yimin Geng, Ankush Gosain, Meghan A. Arnold, Yigit S. Guner, Martin L. Blakely, Cynthia D. Downard, Adam B. Goldin, Julia Grabowski, Dave R. Lal, Roshni Dasgupta, Robert Baird, Robert L. Gates, Julia Shelton, Tim Jancelewicz, Shawn J. Rangel, Mary T. Austin

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

28 Scopus citations


Objective: The goal of this systematic review by the American Pediatric Surgical Association Outcomes and Evidence-Based Practice Committee was to develop recommendations regarding time to appendectomy for acute appendicitis in children within the context of preventing adverse events, reducing cost, and optimizing patient/parent satisfaction. Methods: The committee selected three questions that were addressed by searching MEDLINE, Embase, and the Cochrane Library databases for English language articles published between January 1, 1970 and November 3, 2016. Consensus recommendations for each question were made based on the best available evidence for both children and adults. Results: Based on level 3–4 evidence, appendectomy performed within 24 h of admission in patients with acute appendicitis does not appear to be associated with increased perforation rates or other adverse events. Based on level 4 evidence, time from admission to appendectomy within 24 h does not increase hospital cost or length of stay (LOS). Data are currently limited to determine an association between the timing of appendectomy and parent/patient satisfaction. Conclusions: There is a paucity of high-quality evidence in the literature regarding timing of appendectomy for patients with acute appendicitis and its association with adverse events or resource utilization. Based on available evidence, appendectomy performed within the first 24 h from presentation is not associated with an increased risk of perforation or adverse outcomes. Type of study: Systematic Review of Level 1–4 studies

Original languageEnglish (US)
Pages (from-to)396-405
Number of pages10
JournalJournal of pediatric surgery
Issue number3
StatePublished - Mar 2018


  • Adverse events
  • Appendicitis
  • Delay
  • Systematic review
  • Time to appendectomy

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health


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