Nonoperative treatment of appendicitis linked to higher death rate

Editor's Note

Twice as many patients with appendicitis are being treated without surgery compared to 20 years ago; however, nonoperative management is associated with a higher death rate, finds this study presented October 26 at the American College of Surgeons Clinical Congress 2017 in San Diego.

A total of  477,680 patients in the National Inpatient Sample with a diagnosis of appendicitis between 1998 and 2014 were analyzed. In 135,856 appendicitis patients from 2010 to 2014, the researchers compared patient characteristics and outcomes. 

The researchers found the odds of dying of any cause during hospitalization was 2.4 times higher for patients who did not have surgery. After matching both groups by age, gender, and comorbidities, there was nearly a sixfold increased death rate in the nonoperative group. A total of 0.08% of surgical patients died in the hospital, compared to 0.47% of nonoperative patients.

Surgeons need to consider whether nonoperative management of uncomplicated appendicitis is appropriate for high-risk patients, the authors say.

Nonoperative Treatment of Appendicitis is Increasing, May Raise Death Risk if an Operation is Not Performed

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