Photo Credit: Sirawit99
The study concludes that outpatient appendectomy is a safe and effective treatment for non-complex acute appendicitis, with similar patient satisfaction as inpatient surgery but significantly lower medical costs.
The following is a summary of “Safety, Efficacy, and Cost-effectiveness of Outpatient Surgery for Uncomplicated Acute Appendicitis, The PENDI-CSI Randomized Clinical Trial” published in the January 2024 issue of Surgery by Muñoz-Cruzado, et al.
For a study, researchers sought to find out if an outpatient appendectomy is safe, successful, and a good use of money for people with simple acute appendicitis. It is known that acute appendicitis is the most common cause of acute belly. Creating outpatient appendectomy procedures could make healthcare systems much more effective and long-lasting. From October 2018 to June 2021, 300 patients were registered in the PENDI-CSI randomized clinical study. Of these, 149 were put into the outpatient surgery (OPS) group, and 151 were put into the hospital surgery (IPS) group. The patients were then followed up with one month after surgery. All of the patients were over 14 years old and had severe appendicitis with no other problems. Pregnancy, neoplasms, inflammatory bowel disease, and a high drug risk (ASA IV) were all reasons why the study was not done. The IPS group was admitted, but the OPS group was sent home from the postanesthesia care unit.
Out of the total patients in the OPS group, 128 (85.1%) were sent home without being admitted. Patients in the OPS group were more likely to need to be admitted if they were over 31 years old (relative risk (RR): 2.42; 1.04–5.65), had high blood pressure (RR: 6.21; 3.22–11.97) or had surgery on their abdomen before (RR: 3.34; 1.55–7.20); were in pain after surgery (RR: 4.28; 2.67–6.86); or were afraid after surgery (RR: 2.2; 1.04–4.67). Complications, readmissions, and reinterventions were the same in both groups, and the level of care was thought to be the same. The outpatient method saved €1,034.97 for each patient (P < 0.001).
Outpatient appendectomy is a safe and effective way to treat acute appendicitis that isn’t complex. The way patients feel about the standard of care is similar to IPS, but it does lower medical costs compared to an overnight appendectomy.
