Related Experiment Videos
Same-Day Versus Next-Day Discharge After Laparoscopic Appendectomy for Uncomplicated Appendicitis in Children: A
Lucas Moratilla-Lapeña1,2, Jose Luis Encinas1, Esmeralda Kuan2
1Pediatric Surgery Department, Hospital Universitario La Paz, 28046 Madrid, Spain.
Background:
Same-day discharge after laparoscopic appendectomy for uncomplicated appendicitis has been proposed as a strategy to reduce hospital costs without compromising safety, but evidence in pediatric patients remains limited.
Methods:
We conducted a retrospective study of pediatric patients undergoing laparoscopic appendectomy for uncomplicated appendicitis, comparing same-day and next-day discharge. Baseline differences were addressed using 1:2 propensity score matching. Costs were analyzed using linear regression with cluster-robust standard errors, and inverse probability of treatment weighting was used as a sensitivity analysis.
Results:
Among 102 patients (37 same-day discharge and 65 delayed discharge), 28 same-day discharge patients were matched to 36 delayed-discharge controls. Same-day discharge was associated with a mean reduction in total cost of €319.9 (95% CI: -€413.6 to -€226.2; p < 0.0001), mainly explained by lower admission-related costs, with no significant difference in outpatient consultation costs. Sensitivity analysis using inverse probability weighting in the full cohort showed a similar estimate (-€311.7; 95% CI: -€421.1 to -€202.3; p < 0.0001). Complications were rare and similar in both groups (1/28 vs. 1/36), which limited formal comparison of complication risk.
Conclusions:
Same-day discharge after laparoscopic appendectomy for uncomplicated appendicitis was associated with lower healthcare costs, largely due to reduced admission-related costs, with no apparent signal of increased complications.
Related Concept Videos
Appendicitis-II: Diagnostic Studies and Management
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Appendicitis
Appendicitis-I: Introduction
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...