دورية أكاديمية
Appendicitis Grade, Operative Duration, and Hospital Cost.
| العنوان: | Appendicitis Grade, Operative Duration, and Hospital Cost. |
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| المؤلفون: | Collins CM; Section on Acute Care Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY. Electronic address: courtney.collins@uky.edu., Davenport DL; Section on Acute Care Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY., Talley CL; Section on Acute Care Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY., Bernard AC; Section on Acute Care Surgery, Department of Surgery, University of Kentucky College of Medicine, Lexington, KY. |
| المصدر: | Journal of the American College of Surgeons [J Am Coll Surg] 2018 Apr; Vol. 226 (4), pp. 578-583. Date of Electronic Publication: 2018 Jan 31. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Lippincott Williams & Wilkins, Inc Country of Publication: United States NLM ID: 9431305 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1879-1190 (Electronic) Linking ISSN: 10727515 NLM ISO Abbreviation: J Am Coll Surg Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: 2022- : [Baltimore, MD] : Lippincott Williams & Wilkins, Inc. Original Publication: Chicago, Ill. : The College, c1994- |
| مواضيع طبية MeSH: | Direct Service Costs* , Hospital Costs* , Operative Time*, Appendectomy/*economics , Appendicitis/*diagnosis , Appendicitis/*surgery, Adolescent ; Adult ; Aged ; Aged, 80 and over ; Appendicitis/economics ; Child ; Female ; Hospitalization/economics ; Humans ; Male ; Middle Aged ; Retrospective Studies ; Severity of Illness Index ; Young Adult |
| مستخلص: | 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. (Copyright © 2018 American College of Surgeons. Published by Elsevier Inc. All rights reserved.) |
| التعليقات: | Comment in: J Am Coll Surg. 2018 Apr;226(4):583-585. (PMID: 29576159) |
| تواريخ الأحداث: | Date Created: 20180203 Date Completed: 20190715 Latest Revision: 20220331 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.jamcollsurg.2017.12.046 |
| PMID: | 29391281 |
| قاعدة البيانات: | MEDLINE |
Full Text Finder | تدمد: | 1879-1190 |
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| DOI: | 10.1016/j.jamcollsurg.2017.12.046 |