Poprom Napaphat, Pattanaprateep Oraluck, Wilasrusmee Chumpon, Rattanasiri Sasivimol, McKay Gareth J, Attia John, Thakkinstian Ammarin
Department of Clinical Epidemiology and Biostatistics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Rama VI Road, Bangkok, 10400, Thailand.
Faculty of Public Health, Chiang Mai University, Chiang Mai, Thailand.
Sci Rep. 2025 Apr 29;15(1):14963. doi: 10.1038/s41598-025-00111-5.
Appendicitis is the most common acute abdominal condition affecting general surgical practice. Recently, conservative treatment with antibiotics has been considered as an alternative. Therefore, this study was conducted to evaluate if antibiotics could be cost-effective compared to laparoscopic appendectomy or open appendectomy. A prospective study was undertaken to estimate health-related quality of life for antibiotic and operative treatment, and to ascertain costs in a cohort. A societal perspective incremental cost-effectiveness ratio (ICER) at 1 year after surgery was estimated. A probabilistic sensitivity analyses was performed. ICERs were estimated comparisons between individual antibiotics, laparoscopic appendectomy, and open appendectomy in uncomplicated acute appendicitis. Antibiotics showed improved cost savings compared to operative treatments with an ICER of -113,973.09 USD per quality adjusted life year at 1 year. Based on one year findings, antibiotics represent a lower cost treatment option with better cost-utility compared to operative treatment options in uncomplicated acute appendicitis patients. As such, antibiotic treatment can be initially considered as an alternative option where resources are limited to minimize complication rates associated with operative treatments.
阑尾炎是普通外科最常见的急性腹部疾病。近来，抗生素保守治疗被视为一种替代方法。因此，本研究旨在评估与腹腔镜阑尾切除术或开腹阑尾切除术相比，抗生素治疗是否具有成本效益。开展了一项前瞻性研究，以评估抗生素治疗和手术治疗对健康相关生活质量的影响，并确定一个队列中的成本。估计了术后1年的社会视角增量成本效益比（ICER）。进行了概率敏感性分析。估计了单纯性急性阑尾炎中使用不同抗生素、腹腔镜阑尾切除术和开腹阑尾切除术之间的ICER。与手术治疗相比，抗生素治疗成本更低，术后1年的ICER为每质量调整生命年-113,973.09美元。基于1年的研究结果，对于单纯性急性阑尾炎患者，与手术治疗方案相比，抗生素治疗是一种成本更低且成本效益更好的治疗选择。因此，在资源有限的情况下，可首先考虑抗生素治疗，以尽量降低与手术治疗相关的并发症发生率。
