Study: Non-operative management of pediatric appendicitis cost-effective compared to surgery

Editor's Note

Non-operative management (NOM) with antibiotics for pediatric uncomplicated appendicitis is both less expensive and slightly more effective than urgent laparoscopic appendectomy over a one-year period, according to a study published November 19 in the Journal of the American College of Surgeons. The findings support the viability of NOM as a first-line treatment option in some cases, researchers write. highlighting a growing shift toward antibiotic-first strategies that emphasize patient-centered care and resource optimization.

The economic evaluation used data from a multi-institutional, non-randomized controlled trial comparing NOM and surgery. Outcomes were assessed based on quality-adjusted life years (QALYs), disability-adjusted life years (DALYs), and patient-reported metrics, such as disability days and quality of life. Key findings include:

• Among 1,068 participants, 35% opted for NOM while 65% underwent surgery.
• The average cost per patient for NOM was $8,044, compared to $9,791 for appendectomy.
• NOM resulted in an average of 0.895 QALYs per patient, slightly higher than the 0.884 QALYs for surgery.
• Scenario analyses confirmed that NOM remained cost-effective under various methods of utility measurement.