A survey of the practice and attitudes of surgeons regarding the treatment of appendicitis

D. Dante Yeh, Joseph V. Sakran, Rishi Rattan, Ambar Mehta, Gabriel Ruiz, Howard Lieberman, Michelle Mulder, Nicholas Namias, Tanya Zakrison, Gerd Daniel Pust

Research output: Contribution to journalArticle

Abstract

Background: We surveyed surgeons to document their attitudes, practice, and risk tolerance regarding the treatment of appendicitis. Methods: A web-based survey was sent to the EAST membership. The primary composite endpoint was defined as 1-year incidence of perioperative complications, antibiotic failure, infections, ED visits, and readmissions. Results: A total of 563 of 1645 surveys were completed (34% response). Mean age was 47 ± 10 years and 98% were from the United States. Most (72%) were employed at academic teaching hospitals and 66% practiced in an urban setting. There were significant differences in treatment recommendations for different presentations of appendicitis. Regarding the primary composite endpoint, surgeons would tolerate a median 17% [10%–25%] excess morbidity in order to avoid an operation (i.e. non-inferiority) and would require a median 24% [10%–50% lower morbidity for the surgical approach in order to declare it a superior treatment (i.e. superiority). Conclusions: To be considered non-inferior, antibiotic therapy of appendicitis cannot have >17% excess morbidity and appendectomy must have at least 24% lower morbidity to be considered superior.

Original languageEnglish (US)
Pages (from-to)106-112
Number of pages7
JournalAmerican journal of surgery
Volume218
Issue number1
DOIs
StatePublished - Jul 1 2019

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Appendicitis
Morbidity
Anti-Bacterial Agents
Appendectomy
Therapeutics
Teaching Hospitals
Surgeons
Surveys and Questionnaires
Incidence
Infection

Keywords

  • Appendectomy
  • Appendicitis
  • EAST
  • Survey

ASJC Scopus subject areas

  • Surgery

Cite this

A survey of the practice and attitudes of surgeons regarding the treatment of appendicitis. / Yeh, D. Dante; Sakran, Joseph V.; Rattan, Rishi; Mehta, Ambar; Ruiz, Gabriel; Lieberman, Howard; Mulder, Michelle; Namias, Nicholas; Zakrison, Tanya; Pust, Gerd Daniel.

In: American journal of surgery, Vol. 218, No. 1, 01.07.2019, p. 106-112.

Research output: Contribution to journalArticle

Yeh, D. Dante ; Sakran, Joseph V. ; Rattan, Rishi ; Mehta, Ambar ; Ruiz, Gabriel ; Lieberman, Howard ; Mulder, Michelle ; Namias, Nicholas ; Zakrison, Tanya ; Pust, Gerd Daniel. / A survey of the practice and attitudes of surgeons regarding the treatment of appendicitis. In: American journal of surgery. 2019 ; Vol. 218, No. 1. pp. 106-112.
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