Kırkıl Cüneyt, Karabulut Koray, Aygen Erhan, Ilhan Yavuz Selim, Yur Mesut, Binnetoğlu Kenan, Bülbüller Nurullah
Department of General Surgery, Fırat University, Faculty of Medicine, Elazığ, Turkey.
Ulus Travma Acil Cerrahi Derg. 2013 Jan;19(1):13-9. doi: 10.5505/tjtes.2013.88714.
Unnecessary hospital admissions and negative appendectomies increase healthcare costs of patients with right lower quadrant (RLQ) pain. This study aimed to evaluate the impact on the cost of treatment of appendicitis scoring systems.
Charts were reviewed of patients admitted to the general surgery ward of our hospital with RLQ pain within a year. Alvarado and Lintula scores were calculated, and a simulation was performed to determine the treatment charges that would have been generated had the scoring recommendations been used for admission and surgical decision-making.
Of the 114 admitted patients, 64 (56%) underwent appendectomy. The rate of negative appendectomy was 17.2%. The overall accuracy rates of the Alvarado and Lintula scores for both 'admit' and 'operate' decision-making were 82.7% and 91.9%, respectively (p=0.102). Total charges for the 114 patients were $39,655. If the Alvarado or Lintula score had been used, the total treatment charges would have been $34,087 and $25,772 (p=0.015 and p=0.000), with negative appendectomy rates of 18.5% and 3.6%, respectively.
The implementation of Alvarado and Lintula scores for the decision of hospital admission and appendectomy would have reduced overall treatment charges for acute RLQ pain.
不必要的住院治疗和阴性阑尾切除术增加了右下腹（RLQ）疼痛患者的医疗费用。本研究旨在评估阑尾炎评分系统对治疗费用的影响。
回顾了我院普通外科病房一年内因RLQ疼痛入院患者的病历。计算Alvarado和Lintula评分，并进行模拟，以确定若将评分建议用于入院和手术决策会产生的治疗费用。
114例入院患者中，64例（56%）接受了阑尾切除术。阴性阑尾切除术的发生率为17.2%。Alvarado和Lintula评分对于“入院”和“手术”决策的总体准确率分别为82.7%和91.9%（p = 0.102）。114例患者的总费用为39,655美元。如果使用Alvarado或Lintula评分，总治疗费用将分别为34,087美元和25,772美元（p = 0.015和p = 0.000），阴性阑尾切除术的发生率分别为18.5%和3.6%。
采用Alvarado和Lintula评分进行入院和阑尾切除术决策可降低急性RLQ疼痛的总体治疗费用。
