IMPACT OF SURGERY TIMING ON POSTOPERATIVE OUTCOMES FOLLOWING APPENDECTOMY: A RETROSPECTIVE COHORT STUDY

Abstract

Background: The optimal timing of appendectomy remains a subject of debate, with concerns that nighttime surgery may be associated with worse postoperative outcomes due to factors such as reduced staffing and surgeon fatigue.

Objective: To evaluate the association between the timing of appendectomy (daytime versus nighttime) and postoperative complications and clinical outcomes.

Methods: This retrospective cohort study was conducted at a tertiary care center in Makkah, Saudi Arabia. A total of 183 patients who underwent appendectomy between February and June 2025 were included. Surgeries were categorized as daytime (06:00–17:59) or nighttime (18:00–05:59). Data on patient demographics, clinical characteristics, operative details, and postoperative outcomes were collected. Logistic regression analysis was performed to assess the association between surgery timing and postoperative complications, adjusting for relevant confounders.

Results: Of the 183 patients, 118 (64.5%) underwent daytime surgery and 65 (35.5%) underwent nighttime surgery. Postoperative complications occurred in 21 patients (11.5%), with a higher rate observed in the daytime group compared to the nighttime group (13.6% vs. 7.7%); however, this difference was not statistically significant (p = 0.233). No significant differences were observed between the two groups in terms of ICU admission, length of hospital stay, or postoperative recovery indicators (all p > 0.05).

Conclusion: The timing of appendectomy was not associated with an increased risk of postoperative complications or adverse clinical outcomes. These findings support the safety of performing appendectomy during both daytime and nighttime hours without compromising patient outcomes.