Patient Satisfaction After Outpatient Appendectomy

Outpatient laparoscopic appendectomy has been shown to be safe, with low morbidity and readmission rates, but whether outpatient appendectomy produces poorer patient satisfaction has been questioned. Preoperatively, patients with uncomplicated appendicitis were counselled regarding outpatient management and instructed on postoperative care, follow-up appointments, and contact information. Telephone surveys of patients who underwent an outpatient laparoscopic appendectomy for uncomplicated appendicitis from January through October 2013 were performed. A Likert scale from very dissatisfied (1) to very satisfied (5) was employed. Patients were also queried that if, given the opportunity, they would have chosen to stay in the hospital. Qualified patients included 41 men and 31 women with an average age of 36 years (range 19-79 years). Fifty-four (75%) were reached for satisfaction surveys. Patients were dismissed from the recovery room following a previously published protocol for outpatient management from 6 a.m. to noon (24%), noon to 6 p.m. (17%), 6 p.m. to midnight (22%), and midnight to 6 a.m. (37%). The average satisfaction score for outpatient management was 4.6 (range 2-5). Six patients (11%) stated that they would have preferred hospitalization, if given the opportunity. The reasons included inadequate pain control (2 patients); lack of home assistance (2 patients); nausea and vomiting (1 patient); and prolonged drowsiness (1 patient). Four of these patients violated the outpatient management guidelines (pain controlled on oral analgesics and adequate home assistance). Outpatient laparoscopic appendectomy can be performed with high patient satisfaction, but adherence to protocol guidelines for outpatient management is important to properly select patients for outpatient management and to maximize patient satisfaction.