Effectiveness of patient choice in nonoperative vs surgical management of appendicitis

Editor's Note

When an initial nonoperative management strategy was chosen by patients and families, 3 in 4 children with uncomplicated acute appendicitis avoided surgery at 1-year follow-up, this study finds.

Nonoperative management was associated with fewer days of disability, lower costs, and no difference in rates of complicated appendicitis or health-related quality-of-life scores.

The results of the study reflect the effectiveness of offering nonoperative management to patients and families, the authors say. It allows the patient’s and family’s preferences to be aligned with their choice of therapy, thereby minimizing the effects of treatment preference on outcomes.

Importance Current evidence suggests that nonoperative management of uncomplicated appendicitis is safe, but overall effectiveness is determined by combining medical outcomes with the patient's and family's perspective, goals, and expectations. Objective To determine the effectiveness of patient choice in nonoperative vs surgical management of uncomplicated acute appendicitis in children.