QOL Similar After Surgery, Antibiotics for Uncomplicated Appendicitis

FRIDAY, Feb. 21, 2020 — For patients being treated for uncomplicated acute appendicitis, quality of life (QOL) is similar at seven years after appendectomy or antibiotic therapy, according to a study published online Feb. 19 in JAMA Surgery.

Suvi Sippola, M.D., from Turku University Hospital in Finland, and colleagues assessed postintervention QOL and patient satisfaction and treatment preference during follow-up of a randomized trial comparing appendectomy to antibiotics among patients with acute appendicitis. Overall, 423 patients were available at a median follow-up of seven years: 206 and 217 took antibiotics and underwent appendectomy, respectively.

The researchers found that QOL was similar between the appendectomy and antibiotic groups (median health index value, 1.0 in both groups; 95 percent confidence interval [CI], 0.86 to 1.0; P = 0.96). Satisfaction with the treatment was higher for patients who underwent appendectomy versus those who took antibiotics (68 versus 53 percent very satisfied). No difference was seen in patient satisfaction after successful antibiotic treatment versus appendectomy (cumulative odds ratio [COR], 7.8; 95 percent CI, 0.5 to 1.3; P < 0.36). Satisfaction was higher for patients with appendectomy or successful antibiotic therapy versus antibiotic patients who later underwent appendectomy (CORs, 7.7 [95 percent CI, 4.6 to 12.9; P < 0.001] and 9.7 [95 percent CI, 5.4 to 15.3; P < 0.001], respectively).

“The Appendicitis Acuta trial provides compelling evidence that most patients with acute appendicitis can be treated without surgery,” write the authors of an accompanying editorial.

One author disclosed financial ties to the pharmaceutical industry.

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