Appendicectomy deferred to the next day ;The patient´s opinion


Objective: The aim of this study is to know the opinion of the patients whom had been diagnosed as acute appendicitis and their operations were deferred to the next morning instead of being done at the same night of their admission.
Patients and Methods: 102 consecutive patients admitted to the AL Hilla teaching general hospital from the period of Oct/31/2008 to Feb/28/2009 diagnosed as acute appendicitis were admitted from the causality department .Their operations were deferred to the next day for different reasons. Observations overnight were done and then postoperatively a Questionnaire were given to the patients to know their opinion regarding the deferred operation and their overnight complaining.
Results: 102 patients were studded, their median age 23 years (10 -58 years); 48 males, 54 females. The majority of these patients (48) were presented between10-12pm.
70(68.6 %) patients remembered a reason for deferred operation and the remaining not remembering being given an explanation.
66 (64.7 %) of the patients poorly slept preoperatively, mainly due to the pain and ward noise. Operation on the same night as their admission was the preferred option in 82(80.4%) patients. 67(65.6) patients would have preferred the admitting surgeon to perform their operation; 18(17.6%) expressed no preference and 17(16.6%) patients preferred a 'new' surgeon the following day. Of the 102 patients, 13(12.7%) patients did not know who had performed their operation.
Conclusion: Most patients would prefer not to have their procedure delayed, In spite of being told why their operation was delayed. Major determinant of patient opinion were lack of sleep pre-operatively. Few patients asked for a 'new' surgeon to perform their operation. There is no system arranges the work in our country for cases of acute appendicitis which presented late at night so we need to improve our surgical practice by" Implementation of a guideline to avoid out-of-hours operation done by a junior doctors'.