급성 충수염에서 의사에 의한 수술지연이 수술후 경과에 미치는 영향
Impact of Physician Delay on Postoperative Outcome of Patients with Acute Appendicitis
조병욱, 박성흠, 윤서구, 최경우,
소속 상세정보
조병욱 ( Jo Byung-Wook )
국립의료원 일반외과
박성흠 ( Park Seong-Heum )
국립의료원 일반외과
윤서구 ( Yoon Seo-Koo )
국립의료원 일반외과
최경우 ( Choi Kyung-Woo )
국립의료원 일반외과
KMID : 0356719980140030561
Abstract
Background: It is controversial whether the delay of surgery for acute appendicitis by physician results in higher morbidity. Our present study explores this problem of physician delay on the postoperative outcome of patients with acute appendicitis.
Material and Methods: Among 432 patients admitted for the presumptive diagnosis of acute appendicitis between Jan., 1995 and Dec., 1997, 358 patients with pathologically proven acute appendicits were analyzed. Physician delay from the hospital admission to the surgery was evaluated in relation to the stage of the disease at operation and postoperative outcome.
Results: Postoperative complications occurred signifficantly higher in advanced appendicitis group, than in simple appendicitis group. Postoperative oral consumption started significantly later and hospital days are significantly prolonged in those group. Both patient and physician delays significantly affect the stage of the disease. The finding that physician delay correlated with the stage, however, was denied by multivariate analysis.
Conclusion: On the contrary to the patient delay, physician delay does not affect the stage of the acute appendicitis nor lead to increased incidence of postoperative complication. Physician delay to clarify the diagnosis is a reasonable strategy and it does not affect the outcome adversely.
키워드
Physician delay;Acute appendicitis
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