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Two studies offer additional evidence to support the nonoperative management of uncomplicated appendicitis.
One study evaluated 230,000 California patients of all ages admitted between 1997 and 2008. Those undergoing appendectomy were compared with a small, propensity-matched, nonoperatively managed cohort (3236 patients; 1.5%). The nonoperative-treatment failure rate was 5.9%, occurring at an average of 6 days; the recurrence rate was 4.2%, occurring around 2 years. Nonoperative patients had longer lengths of stay (mean, 3.2 vs. 2.1 days). Mean total charges and in-hospital and 30-day mortality rates were similar between groups.
The second study evaluated 77 Ohio patients between ages 7 and 17 years; patients and their families chose operati…