Background: Intra-abdominal abscess, the most common complication after perforated appendicitis, is associated with considerable economic burden. However, costs of intra-abdominal abscesses in children are unknown. We aimed to evaluate resource utilization and costs attributable to intra-abdominal abscess in pediatric perforated appendicitis.
Methods: A single-center retrospective analysis was performed of children (<18 years) who underwent appendectomy for perforated appendicitis (2013-2019). Hospital costs incurred during the index admission and within 30 postoperative days were obtained from the hospital accounting system and inflated to 2019 USD. Generalized linear models were used to determine excess resource utilization and costs attributable to intra-abdominal abscess after adjusting for confounders.
Results: Of 763 patients, 153 (20%) developed intra-abdominal abscesses. Eighty-one patients with intra-abdominal abscesses (53%) underwent percutaneous abscess drainage. Intra-abdominal abscess was independently associated with a nearly 8-fold increased risk of 30-day readmission (adjusted risk ratio, 7.8 [95% confidence interval, 4.7-13.0]). Patients who developed an intra-abdominal abscess required 6.1 excess hospital bed days compared to patients without intra-abdominal abscess (95% confidence interval, 5.3-7.0). Adjusted mean hospital costs for patients with intra-abdominal abscess totaled $27,394 (95% confidence interval, $25,688-$29,101) versus $15,586 (95% confidence interval, $15,102-$16,069) for patients without intra-abdominal abscess. Intra-abdominal abscess was associated with an incremental cost of $11,809 (95% confidence interval, $10,029-$13,588). Hospital room costs accounted for 66% of excess costs.
Conclusion: Postoperative intra-abdominal abscess nearly doubled pediatric perforated appendicitis costs, primarily due to more hospital bed days and associated room costs. Intra-abdominal abscesses resulted in estimated excess costs of $1.8 million during the study period. Even small reductions in intra-abdominal abscess rates or hospital bed days could yield substantial health care savings.
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http://dx.doi.org/10.1016/j.surg.2022.01.042 | DOI Listing |
Cureus
December 2024
General Surgery, King's College Hospital London, Dubai Hills, Dubai, ARE.
Idiopathic megacolon and megarectum are rare clinical conditions characterized by irreversible dilation of the colon and rectum without an identifiable organic cause. The underlying pathophysiology remains poorly understood, though hypotheses suggest abnormalities in the enteric nervous system or smooth muscle dysfunction. These conditions present significant diagnostic and therapeutic challenges, especially in cases refractory to conservative treatment.
View Article and Find Full Text PDFCureus
December 2024
Trauma and Acute Care Surgery, Prince Sultan Military Medical City, Riyadh, SAU.
Jejunal diverticulum perforation is a rare condition and presents diagnostic challenges. A 41-year-old male presented to the emergency room with a history of vague, generalized, and continuous abdominal pain for two days. He was vitally stable; however, the abdominal examination revealed a soft and distended abdomen with positive rebound tenderness.
View Article and Find Full Text PDFSurgery
January 2025
Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
Background: We previously reported that the balance of short-chain fatty acids and lactic acid in feces affects postoperative infectious complications after major hepatectomy. However, the effect remains unclear in pancreaticoduodenectomy.
Methods: Preoperative fecal samples were collected from 210 patients who underwent pancreaticoduodenectomy at 2 institutions between January 2019 and June 2021.
J Abdom Wall Surg
December 2024
Anesthesiology and Critical Care Department, Pellegrin University Hospital, Bordeaux, France.
Introduction: In critically ill surgical patients treated with open abdomen and negative pressure therapy (OA/NPT), the association between nutritional support and clinical outcome is still controversial. The main objective of this study was to assess the effect of enteral nutritional support during the acute phase (i.e.
View Article and Find Full Text PDFTrop Doct
January 2025
MD, Senior Resident, Department of Gastroenterology, All India Institute of Medical Sciences, Patna, Bihar, India.
Amoebic liver abscess (ALA), a common tropical infection, is caused by (EH). For decades, the first-line treatment for ALA has been metronidazole which has several drawbacks. The thioredoxin reductase enzyme in EH is essential for its anti-oxidative defence and survival during tissue invasion.
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