We have located links that may give you full text access.
Appendicitis Grade, Operative Duration, and Hospital Cost.
Journal of the American College of Surgeons 2018 April
BACKGROUND: The American Association for the Surgery of Trauma (AAST) established a grading system for appendicitis to allow prediction of risk and outcomes, to assist in quality improvement and resource management, and to provide a framework for research. Grading is determined in clinical, imaging, operative, and pathologic categories, but has not been completely validated. Our aim was to validate appendicitis grade with respect to duration of symptoms, operative duration, and hospital costs.
STUDY DESIGN: We performed a retrospective medical record review, working backward until at least 40 of each grade of appendicitis were reviewed. Patients 8 years old and younger and those treated nonoperatively were excluded. Appendicitis severity was determined using the AAST grading scale (I to V), with V being the most severe. Statistical comparisons were made between increased grade and duration of symptoms, operative duration, hospital costs, and revenue. Data were analyzed using ANOVA or chi-square tests as appropriate.
RESULTS: A total of 1,099 appendectomies performed between August 2013 and December 2016 were analyzed. Most were low grade. Median age was 18 years old, and 44.4% were female. Patients with increasing AAST grade had a longer symptom duration (p < 0.001), longer operative duration (p < 0.001), increased direct costs (p < 0.001) in every category measured (operating room, pharmacy, imaging, lab), and contribution margin (p < 0.001).
CONCLUSION: The AAST appendicitis grade is a valid predictor of disease severity as defined by operative duration, hospital cost, and revenue. Duration of symptoms predicts severity. Appendicitis grade can be used in clinical care, residency training, and resource allocation.
STUDY DESIGN: We performed a retrospective medical record review, working backward until at least 40 of each grade of appendicitis were reviewed. Patients 8 years old and younger and those treated nonoperatively were excluded. Appendicitis severity was determined using the AAST grading scale (I to V), with V being the most severe. Statistical comparisons were made between increased grade and duration of symptoms, operative duration, hospital costs, and revenue. Data were analyzed using ANOVA or chi-square tests as appropriate.
RESULTS: A total of 1,099 appendectomies performed between August 2013 and December 2016 were analyzed. Most were low grade. Median age was 18 years old, and 44.4% were female. Patients with increasing AAST grade had a longer symptom duration (p < 0.001), longer operative duration (p < 0.001), increased direct costs (p < 0.001) in every category measured (operating room, pharmacy, imaging, lab), and contribution margin (p < 0.001).
CONCLUSION: The AAST appendicitis grade is a valid predictor of disease severity as defined by operative duration, hospital cost, and revenue. Duration of symptoms predicts severity. Appendicitis grade can be used in clinical care, residency training, and resource allocation.
Full text links
Trending Papers
A Personalized Approach to the Management of Congestion in Acute Heart Failure.Heart International 2023
Potential Mechanisms of the Protective Effects of the Cardiometabolic Drugs Type-2 Sodium-Glucose Transporter Inhibitors and Glucagon-like Peptide-1 Receptor Agonists in Heart Failure.International Journal of Molecular Sciences 2024 Februrary 21
The Effect of Albumin Administration in Critically Ill Patients: A Retrospective Single-Center Analysis.Critical Care Medicine 2024 Februrary 8
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app