{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T01:03:03Z","timestamp":1791594183190,"version":"4.3.4"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,9]],"date-time":"2020-12-09T00:00:00Z","timestamp":1607472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Aim<\/jats:title><jats:p>This study aimed to explore factors may affect the length of hospital stay after laparoscopic appendectomy.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>The data of 636 patients undergoing laparoscopic appendectomy between July 2016 and July 2019 in Beijing Tsinghua Changgung Hospital were retrospectively analyzed. The patients were divided into group A (hospital stay \u22643 days, 348 patients) and group B (hospital stay &gt;3 days, 288 patients) according to their hospital stay.Sex, age, disease onset time(time from onset to admission), nausea, vomiting, diarrhea, peritonitis, comorbidities, and history of appendicitis; preoperative body temperature (T), white blood cell (WBC) count, percentage of neutrophilic granulocytes, and preoperative C-reactive protein (CRP) level; time from diagnosis to surgery. appendix diameter, appendicolith, and ascites in ultrasound or CT; surgical time(the surgery start time was the time of skin incision, and the end time was the time the anesthesia intubation was removed), intraoperative blood loss (the volume of blood infiltrating into a gauze was calculated by weighing the gauze infiltrated with water and calculating the volume of water), intraoperative adhesions or effusions, and stump closure methods, convert to open appendectomy, appendix pathology(perforated or gangrenous appendicitis were defined as complicated appendicitis and simple or suppurative appendicitis were defined as uncomplicated appendicitis) and antibiotic treatment schemes were analyzed.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>Significant differences were detected between group A and group B in age (37.10 \u00b1 13.52y vs 42.94 \u00b1 15.57y,<jats:italic>P<\/jats:italic>&lt;0.01), disease onset time (21.36 \u00b1 16.56 h vs 32.52 \u00b1 27.99 h,<jats:italic>P<\/jats:italic>&lt;0.01), time from diagnosis to surgery (8.63 \u00b1 7.29 h vs 10.70 \u00b1 8.47 h,<jats:italic>P<\/jats:italic>&lt;0.01); surgical time(64.09 \u00b1 17.24 min vs 86.19 \u00b1 39.96 min,<jats:italic>P<\/jats:italic>&lt; 0.01); peritonitis(52.9% vs 74%,<jats:italic>P<\/jats:italic>&lt; 0.01), comorbidities (12.4% vs 20.5%,<jats:italic>P<\/jats:italic>&lt; 0.01), appendicolith (27.6% vs 41.7%,<jats:italic>P<\/jats:italic>&lt; 0.01), ascites before the surgery(13.8% vs 22.9%,<jats:italic>P<\/jats:italic>&lt; 0.01), intraoperative adhesions or effusions(56% vs 80.2%,<jats:italic>P<\/jats:italic>&lt; 0.01); preoperative temperature (37.11 \u00b1 0.64\u00b0C vs 37.54 \u00b1 0.90\u00b0C,<jats:italic>P<\/jats:italic>&lt; 0.01); preoperative WBC count (13.06 \u00b1 3.39 \u00d7 109\/L vs 14.21 \u00b1 4.54 \u00d7 109\/L,<jats:italic>P<\/jats:italic>= 0.04);preoperative CRP level(18.99 \u00b1 31.72 mg\/L vs 32.46 \u00b1 46.68 mg\/L,<jats:italic>P<\/jats:italic>&lt; 0.01); appendix diameter(10.22 \u00b1 2.59 mm vs 11.26 \u00b1 3.23 mm,<jats:italic>P<\/jats:italic>&lt; 0.01); intraoperative blood loss (9.36 \u00b1 7.29 mL vs 13.74 \u00b1 13.49 mL,<jats:italic>P<\/jats:italic>&lt; 0.01); using Hem-o-lok for stump closure(30.7% vs 38.5%,<jats:italic>P<\/jats:italic>= 0.04); complicated appendicitis (9.5% vs 45.8%,<jats:italic>P<\/jats:italic>&lt; 0.01); and using ertapenem for antibiotic treatment after the surgery(4.3% vs 21.5%,<jats:italic>P<\/jats:italic>&lt; 0.01). Multivariate analysis demonstrated that age (OR = 1.021; 95%CI = 1.007\u20131.036), peritonitis (OR = 1.603; 95% CI = 1.062\u20132.419), preoperative WBC count (OR = 1.084; 95% CI = 1.025\u20131.046), preoperative CRP level (OR = 1.010; 95% CI = 1.005\u20131.015), time from diagnosis to surgery (OR = 1.043; 95% CI = 1.015\u20131.072), appendicolith (OR = 1.852; 95% CI = 1.222\u20132.807), complicated appendicitis (OR = 3.536; 95% CI = 2.132\u20135.863), surgical time (OR = 1.025; 95% CI = 1.016\u20131.034), use of Hem-o-lok for stump closure (OR = 1.894; 95% CI = 1.257\u20132.852), and use of ertapenem for antibiotic treatment (OR = 3.076; 95% CI = 1.483\u20136.378) were the risk factors for a prolonged hospital stay.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusions<\/jats:title><jats:p>The patient with appendicitis was older and had peritonitis, higher preoperative WBC count or CRP level, longer time from diagnosis to surgery, appendicolith, and complicated appendicitis, predicting a prolonged hospital stay. Shorter surgical time and the use of silk ligation for stump closure and cephalosporins + metronidazole for antibiotic treatment might be better choices to obtain a shorter hospital stay.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0243575","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T00:17:15Z","timestamp":1607559435000},"page":"e0243575","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":20,"title":["Factors affecting the length of hospital stay after laparoscopic appendectomy: A single center study"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3509-6191","authenticated-orcid":true,"given":"Peng","family":"Zhang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qian","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongwei","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuanxin","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2020,12,9]]},"reference":[{"key":"pone.0243575.ref001","doi-asserted-by":"crossref","first-page":"j1703","DOI":"10.1136\/bmj.j1703","article-title":"Acute appendicitis","volume":"357","author":"DLH Baird","year":"2017","journal-title":"BMJ"},{"issue":"10000","key":"pone.0243575.ref002","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/S0140-6736(15)00275-5","article-title":"Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management","volume":"386","author":"A Bhangu","year":"2015","journal-title":"Lancet"},{"issue":"6","key":"pone.0243575.ref003","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1097\/TA.0000000000001030","article-title":"Antibiotics for appendicitis! 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