Nonoperative Management Cost-Effective for Pediatric Appendectomy

WEDNESDAY, Dec. 4, 2024 (HealthDay News) — Nonoperative management (NOM) is cost-effective for pediatric uncomplicated appendicitis compared with laparoscopic appendectomy, according to a study published online Nov. 19 in the Journal of the American College of Surgeons.

Lindsay A. Gil, M.D., M.P.H., from the Abigail Wexner Research Institute at the Nationwide Children”s Hospital in Columbus, Ohio, and colleagues evaluated the cost-effectiveness of nonoperative (antibiotics alone) versus operative management for pediatric uncomplicated acute appendicitis. The analysis included data from 1,068 patients.

The researchers found that 35 percent selected NOM and 65 percent selected urgent laparoscopic appendectomy. Operative management cost an average of $9,791 per patient and yielded an average of 0.884 quality-adjusted life years (QALY). In contrast, NOM cost an average of $8,044 per patient and yielded an average of 0.895 QALYs. Using disability days and alternate methods of calculating utilities, NOM was both less costly and more effective in base case and scenario analyses.

“Our study findings add an additional benefit to the antibiotics-only approach being safe and effective for children in that this strategy is shown to be cost-effective,” coauthor Peter C. Minneci, M.D., of Nemours Children”s Health in Wilmington, Delaware, said in a statement. “In short, nonoperative management is a safe and cost-effective initial therapy and a reasonable alternative to surgery.”

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