Economic Evaluation of Acute Appendicitis Therapeutic Interventions: A Systematic Review

Abstract

Background and Aims

Acute appendicitis (AA) is a prevalent cause of lower abdominal pain, often leading patients to seek emergency department care, particularly among young individuals. The present study aimed to systematically review cost-effectiveness studies focusing on therapeutic interventions for AA.

Method

Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed economic evaluations of AA treatments published between 2000 and 2020. We searched multiple databases, including Cochrane, PubMed, Scopus, and Web of Science. The studies included in this review were assessed using the Quality of Health Economic Studies (QHES) checklist, and cost data were standardized to 2022 US dollars.

Results

Out of the 53 screened studies, 11 fulfilled the inclusion criteria. The studies’ average QHES score was of high quality (0.87). Most studies were from the payer's perspective and the health system (four studies each). Five studies were based on the decision tree model, and three were based on the Markov model. Four studies were conducted on children. Of the 11 studies reviewed, five support the cost-effectiveness of laparoscopy, five support the cost-effectiveness of antibiotic therapy, and one supports the cost-effectiveness of open appendectomy.

Conclusions

Based on the findings of this study, laparoscopic therapeutic intervention, compared to open appendectomy, can be more cost-effective for the treatment of patients with AA.