Propensity Score-Matched Analysis of Fast Track Pathway versus Conventional Pathway for Acute Perforated Appendicitis Patients with Type 2 Diabetes

Weijie Chen, Shengnan Zhou, Jianchun Xiao, Qiang Qu and Xiaodong He*

Department of General Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, P. R. China

^*Correspondance to: Xiaodong He 

 PDF  Full Text DOI: 10.25107/2474-1647.3410

Abstract

Objective: The implementation of fast track pathways in perforated appendicitis patients with diabetes remains challenging. Our aim was to investigate the feasibility of our fast track pathway. Methods: We reviewed a series of patients on a fast track pathway recovery (FP group) and patients on a conventional pathway recovery (CP group) between January 2019 and December 2020, and used a propensity score matched comparison to analyze outcomes. Results: The study included 96 acute perforated appendicitis patients with diabetes, 35 pairs of patients were successful matched according to levels of the white blood level, fasting blood glucose level and hemoglobin A1c level using propensity scores. In the matched cohort, the surgery duration in the FP group was shorter than that of the CP group (38.4 ± 9.1 min vs. 58.1 ± 8.7 min, P<0.001). The patients in the FP group suffered less pain (VAS, 2.7 ± 0.7 vs. 4.3 ± 1.1, P<0.001), stayed shorter in hospital (2.2 ± 0.5 d vs. 6.0 ± 1.5 d, P<0.001), and generated lower hospital costs (15442.6 ± 6306.3 Yuan vs. 26025.9 ± 10443.7 Yuan, P<0.001) than that did patients in the CP group. Besides, the rate of complication occurrence did not increase in the FP group. Conclusion: The fast track pathway offers significant fast recovery and healthcare saving without increasing postoperative morbidity.

Keywords

Emergency medical services; Perforated appendicitis; Diabetes

Cite the article

Chen W, Zhou S, Xiao J, Qu Q, He X. Propensity Score-Matched Analysis of Fast Track Pathway versus Conventional Pathway for Acute Perforated Appendicitis Patients with Type 2 Diabetes. Clin Surg. 2022; 7: 3410.