Santos Ludmilla Candido, Gao Jingya, Filho Ronaldo C Fabiano, Mejia Piero F, Robinson Lacey B, Camargo Carlos A
Massachusetts General Hospital, Department of Emergency Medicine, Boston, United States
Massachusetts General Hospital Department of Medicine, Division of Rheumatology, Allergy and Immunology, Boston, United States
Turk J Anaesthesiol Reanim. 2025 May 30;53(3):122-131. doi: 10.4274/TJAR.2025.241755. Epub 2025 May 16.
Appendectomy for acute appendicitis is the most common acute surgical procedure in children. Recent changes in appendicitis management have likely modified the nature and cost of hospitalizations for this condition.
Using data from the National Inpatient Sample from 2001 to 2017, we performed a cross-sectional study and identified the temporal changes in hospitalization for appendectomy. Changes in relative hospitalization cost and length-of-stay were also studied to assess their associations with the changes in procedure incidence. Patient and hospital characteristics were considered to understand outcome disparities between groups. Geographic variation in the outcomes was also identified at the United States region and division levels.
The incidence of appendectomy hospitalization decreased from 11.2 to 6.4 per 10,000 person-years between 2001 and 2017. Conversely, the median procedure cost increased 61% during this same period. The temporal changes in appendectomy hospitalization varied according to patient and hospital characteristics, as well as geographic locations.
The overall incidence of appendectomies in children decreased substantially from 2001 to 2017, yet the trend for costs was in the opposite direction. The data on the clinical factors driving these trends can be useful in guiding policies with evidence-based guidelines that help optimize clinical decisions and the effective use of resources in the management of appendicitis.
阑尾切除术是儿童最常见的急性外科手术。阑尾炎治疗方法的近期变化可能改变了该病住院治疗的性质和费用。
利用2001年至2017年全国住院患者样本的数据，我们进行了一项横断面研究，并确定了阑尾切除术住院治疗的时间变化。还研究了相对住院费用和住院时间的变化，以评估它们与手术发生率变化的关联。考虑患者和医院的特征，以了解不同组之间的结果差异。还在美国地区和分区层面确定了结果的地理差异。
2001年至2017年期间，阑尾切除术住院发生率从每10000人年11.2例降至6.4例。相反，同期手术费用中位数增加了61%。阑尾切除术住院治疗的时间变化因患者和医院特征以及地理位置而异。
2001年至2017年，儿童阑尾切除术的总体发生率大幅下降，但费用趋势却相反。有关推动这些趋势的临床因素的数据，有助于以循证指南指导政策制定，优化阑尾炎管理中的临床决策和资源有效利用。
