Laparoscopic treatment of perforated appendicitis

Table 1 Summary of the population-based studies on the mortality and morbidities for patients with perforated appendicitis in United States

Study	Patient numbers	Mortality	Overall morbidities	30-d readmission	Wound infection	IAA	Bowel obstruction
Tuggle et al[12]	LA: 2060	LA: 0.54%	-	-	LA: 2.56%b	LA: 6.74%b	-
	OA: 730	OA: 1.11%			OA: 8.05%	OA: 3.69%
		(P = 0.11)
Tiwari et al[16]	LA: 5212	LA : 0.13%b	LA: 17.43%b	LA: 5.04%	-	-	-
	OA: 5323	OA: 1.03%	OA: 26.68%	OA: 5.93% (P = 0.05)
Masoomi et al[6]	LA: 69840	LA: 0.06%b	LA: 18.75%b	-	LA: 0.58%b	LA: 1.65%b	LA: 1.24%b
	OA: 68344	OA: 0.31%	OA: 26.76%		OA: 2.09%	OA: 3.57%	OA: 2.84%
Oyetunji et al[13]	Total 72787	-	-	-	-	LA: 4.9%	-
	LA: 29.2%					OA: 3.8%
	OA: 70.8%
Jen et al[45]	LA: 9246	-	-	LA: 6.3%	LA: 5.5%	-	LA: 2.0%
	OA: 21347			OA: 6.9%	OA: 6.4%		OA: 2.6%
				(P = 0.16)	(P = 0.02)		(P = 0.02)

^bP < 0.01 vs perforated appendicitis (OA) group. LA: Laparoscopic appendectomy; IAA: Intra-abdominal abscess.

Table 2 Population-based studies of patients with perforated appendicitis in United States: Profiles of study, length of stay, and medical costs

Study	Patient population	Data source	Study period	Patient numbers	Length of hospital stay, d	Medical costs, USD
Tuggle et al[12]	Adults	NSQIPD	2005-2007	LA: 2060, OA: 730	LA: 3.97b	-
					OA: 5.13
Tiwari et al[16]	Adults	UHCD	2006-2008	LA: 5212	LA: 4.34b	LA: 12125b
				OA: 5323	OA: 7.31	OA: 17594
Masoomi et al[6]	Adults	NISD	2006-2008	LA: 69840	LA: 4.0b	LA: 32487b
				OA: 68344	OA: 6.0	OA: 38503
Oyetunji et al[13]	Children < 18 yr	HCUP	1998-2007	Total: 72787	LA: 5.06b	LA: 27951b
				LA: 29.2%	OA: 5.60	OA: 24965
				OA: 70.8%
Jen et al[45]	Children < 18 yr	CAPDD	1999-2006	LA: 9246	LA: 5.2b	-
				OA: 21347	OA: 5.5

^bP < 0.01 vs perforated appendicitis (OA) group. NISD: Nationwide Inpatient Sample Database; UHCD: University Health System Consortium Database; HCUP: Healthcare Cost and Utilization Project; CAPDD: California Patient Discharge Database; NSQIPD: (American College of Surgeon’s) National Surgical Quality Improvement Project Database; LA: Laparoscopic appendectomy; IAA: Intra-abdominal abscess.

Table 3 Summary of 2 population-bases studies for elderly patients with perforated appendicitis

Study	Harrell et al[76]	Masoomi et al[6]
Study period	1997-2003	2006-2008
Data source	NCHAPD	NISD
Patient numbers	LA: 203, OA: 1289	LA: 13765, OA: 18915
Length of hospital stay, d	LA: 6.8, OA: 9.0b	LA: 5.8, OA: 8.7b
Routine discharge	LA: 86.6%, OA: 70.9%b	-
Mortality	LA: 1.0%, OA: 2.98%	LA: 1.4%, OA: 2.63%b
	(P = 0.10)
Overall complication rate	LA: 23.65%, OA: 23.74%	LA: 36.27%, OA: 46.92%b
	(P = 0.97)
Surgical charge, USD	LA: 22334, OA: 23855	LA: 47339, OA: 57963b
	(P = 0.93)

^bP < 0.01 vs perforated appendicitis (OA) group. NISD: Nationwide Inpatient Sample Database; NCHAPD: North Carolina Hospital Association Patient Data; LA: Laparoscopic appendectomy.

Table 4 Summary of 2 population-bases studies for obese patients with perforated appendicitis

Study	Varela et al[80]	Masoomi et al[6]
Study period	2002-2007	2006-2008
Data source	UHCD	NISD
Patient numbers	LA: 238, OA: 441	LA: 6769, OA: 7110
Definition of obesity	BMI ≥ 40 kg/m2	BMI ≥ 30 kg/m2
Length of hospital stay, d	LA: 5, OA: 7b	LA: 4.4, OA: 6.5b
Mortality	LA: 0%, OA: 0%	LA: 0%, OA: 0.50%b
Overall complication rate	LA: 18%, OA: 27%b	LA: 22.34%, OA: 34.65%b
Mean costs, USD	LA: 12300, OA: 16600b	LA: 36483, OA: 43901b

^bP < 0.01 vs perforated appendicitis (OA) group. NISD: Nationwide Inpatient Sample Database; UHCD: University Health System Consortium Database; LA: Laparoscopic appendectomy; BMI: Body mass index.