ArticleThe Journal of surgical research2020
An Evidence-Based Care Protocol Improves Outcomes and Decreases Cost in Pediatric Appendicitis.
Article in The Journal of surgical research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
6 citing papers in PubMed, 1 synthesis or guideline pooled it, 16 citations in OpenAlex.
- A systematic review of risk stratification for pediatric appendicitis.Pediatric surgery international · 2025Pooled it
- Inter-Rater Reliability Of Assigning A Pediatric Appendicitis Grade: An International Multicenter Study By The Canadian Consortium For Research In Pediatric Surgery (CanCORPS).Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2026Article
- Hospitalization costs of pediatric acute appendicitis in Western Romania: a single-center retrospective study.Journal of medicine and life · 2026Article
- Better care for children with appendicitis: implementation of antibiotic stewardship optimizes postoperative therapy.GMS hygiene and infection control · 2025Article
- Do Unpaid Children's Hospital Account Balances Correlate with Family Income or Insurance Type?Plastic and reconstructive surgery. Global open · 2023Article
- Value Added from Same-day Discharge after Appendectomy for Children with Simple Appendicitis.Pediatric quality & safetyArticle
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Authors and funding
8 authors at 2 institutions in 1 country.
Funding
Abstract
backgroundAppendicitis is a common indication for urgent abdominal surgery in the pediatric population. The postoperative management varies significantly in time to discharge and cost of care. The objective of this study was to investigate whether implementation of an evidence-based protocol after an appendectomy would lead to decreased length of stay and cost of care.
methodsIn 2014 at the Children's Hospital of Pittsburgh, an initiative to develop an evidenced-based protocol to treat appendicitis was undertaken. A work group was formed of pediatric surgeons and other important personnel to determine best practices. Treatment pathways were created. Pathways differed with recommendation on postoperative antibiotic choice and duration, diet initiation, and discharge criteria. Data were prospectively gathered from all patients (ages 0-18 y) with acute appendicitis from January 2015 to December 2016. Primary outcomes were length of stay and cost of care. Secondary outcomes were surgical site infection, readmission rate, and duration of postoperative antibiotics.
resultsAmong the 1289 patients, 481 patients were in the preprotocol cohort and 808 patients were in the postprotocol cohort. 27% of patients had an intraoperative diagnosis of complicated appendicitis. There was a significantly shorter length of stay in the postprotocol cohort (P < 0.001). Median costs for the whole cohort decreased 0.6% and 24.6% for patients with complicated appendicitis after protocol initiation (P < 0.01).
conclusionsThis study has demonstrated that introduction of an evidence-based clinical care protocol for pediatric patients with appendicitis leads to shorter hospital stay and decreased hospital costs.
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