{"id":21116,"date":"2024-10-16T09:43:55","date_gmt":"2024-10-16T13:43:55","guid":{"rendered":"https:\/\/www.ices.on.ca\/?post_type=journal_article&#038;p=21116"},"modified":"2025-01-31T09:49:51","modified_gmt":"2025-01-31T14:49:51","slug":"long-term-outcomes-following-non-operative-management-of-acute-appendicitis","status":"publish","type":"journal_article","link":"https:\/\/www.ices.on.ca\/fr\/publications\/journal-articles\/long-term-outcomes-following-non-operative-management-of-acute-appendicitis\/","title":{"rendered":"Long-term outcomes following non-operative management of acute appendicitis: a population-based analysis"},"content":{"rendered":"<p><strong>Objective <\/strong>\u2014 To describe long-term re-presentations and interventions following non-operative management (NOM) of acute appendicitis (AA).<\/p>\n<p><strong>Summary background data <\/strong>\u2014 Trial data suggest NOM of AA carries a substantial risk of subsequent appendectomy, although NOM is increasingly offered to patients. Population-based data is required to understand the real-world long-term course of patients undergoing NOM of AA.<\/p>\n<p><strong>Methods<\/strong> \u2014 This population-based cohort study included all adult patients in Ontario, Canada who presented to any emergency department (ED) with AA between 2004-2019. Patients who did not undergo a procedure on index ED presentation or hospital admission were defined as NOM and followed for five years. The cumulative incidence of composite re-presentation or intervention (ED re-presentation, re-admission, emergency, or scheduled appendicitis procedure) was calculated accounting for competing risk of death.<\/p>\n<p><strong>Results<\/strong> \u2014 Of 156,362 patients identified with AA, 13,200 underwent NOM. The cumulative incidence of composite re-presentation or intervention was 33% at 1-year (95%CI 32-33%) and 36% at 5-years (95%CI 36-37%). At 5-years, the incidence of appendicitis-specific ED re-presentation or hospital re-admission was 16% (95%CI 15-16%), the incidence of an emergency procedure for AA was 12% (95%CI 12-13%), and the incidence of scheduled surgery was 21% (95%CI 20-21%). In a subgroup of patients with uncomplicated AA, composite re-presentation or intervention was 28% at 1-year (95%CI 27-29%) and 32% at 5-years (95%CI 32-33%).<\/p>\n<p><strong>Conclusions<\/strong> \u2014 Real-world estimates of emergency re-presentation with or without urgent surgery following NOM of AA were lower than previously described. Scheduled appendectomy made up an important proportion of long-term interventions following NOM.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Objective \u2014 To describe long-term re-presentations and interventions following non-operative management (NOM) of acute appendicitis (AA). Summary background data \u2014 Trial data suggest NOM of AA carries a substantial risk of subsequent appendectomy, although NOM is increasingly offered to patients. Population-based data is required to understand the real-world long-term course of patients undergoing NOM of [&hellip;]<\/p>\n","protected":false},"template":"","migration-helper-automated":[],"migration-manual":[],"topic":[62,46],"migration-helper-qa-sample-set":[],"class_list":["post-21116","journal_article","type-journal_article","status-publish","hentry","topic-health-services-research","topic-internal-medicine"],"acf":{"citation":"Telesnicki T, Nantais J, De Mestral C, de Buck van Overstraeten A, Gomez D. <em>Ann Surg<\/em>. 2024; Oct 16 [Epub ahead of print].","source_url":"https:\/\/doi.org\/10.1097\/sla.0000000000006555","ices_scientist":[1219,1241],"site":[6733],"research_program":[6745],"news_release":"","journal_article":"","atlas":"","research_report":"","infographic":"","video":"","downloads":null,"links":null,"sitecore_item_id":"","sitecore_item_name":"","sitecore_field_values":"","previous_url":""},"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ICES | Long-term outcomes following non-operative management of acute appendicitis: a population-based analysis<\/title>\n<meta name=\"description\" content=\"Objective \u2014 To describe long-term re-presentations and interventions following non-operative management (NOM) of acute appendicitis (AA). 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