- Years after treatment for acute uncomplicated appendicitis (AUA), QoL was similar for patients whether they had undergone successful antibiotic or surgical treatment.
- Authors call for research to identify risk factors for surgery after initial antibiotic treatment.
Why this matters
- Although criticized, results of the APPAC multicenter randomized clinical trial suggested that antibiotic treatment of AUA is safe and effective.
- QoL after appendectomy vs antibiotics:
- Similar median health index value between groups (P=.96).
- Similar self-rated health on 100-point scale: 79.7 with surgery (95% CI, 77.7-81.7) vs 79.5 (77.5-81.4) with antibiotics (P=.65).
- Of 206 patients who took antibiotics, 81 (39%) later underwent appendectomy.
- Satisfaction with care:
- Higher for appendectomy vs antibiotic group overall (P=.001).
- No different between the appendectomy group and successful-antibiotic subgroup (P=.36).
- Higher for the appendectomy group overall vs later-appendectomy subgroup (P<.001>
- Higher for successful-antibiotic subgroup vs later-appendectomy subgroup (P<.001>
- Secondary analysis of APPAC (n=423).
- Adults with CT-confirmed AUA had been randomly assigned to antibiotic treatment vs open appendectomy.
- Outcome: QoL at median 7 years after intervention.
- Funding: Mary and Georg C. Ehrnrooth Foundation; Finnish government.
- Laparoscopic appendectomy is now standard of care.
- Post hoc QoL measure, with no baseline for comparison.