Diabetes mellitus and cerebrovascular disease as independent determinants for increased hospital costs and length of stay in open appendectomy in comparison with laparoscopic appendectomy: a nationwide cohort study.

摘要

Comorbidity has been proven to increase hospital costs and length of hospitalstays in patients receiving appendectomy for the treatment of acute appendicitis.However, the specific comorbidities that independently influence discrepancy ofhospital costs and length of stay between open appendectomy and laparoscopicappendectomy still need to be elucidated. Using multivariate linear analysis,administrative claims data were obtained from Taiwan's National Health Institute Research Database to compare differences of hospitalization costs and length ofstay between open appendectomy and laparoscopic appendectomy categorized byvarious comorbidities defined in Charlson comorbidity score. Of 103,653 patients,81,479 open appendectomies and 22,174 laparoscopic appendectomies were performed for the treatment of acute appendicitis in Taiwan between 2004 and 2008. Inmultilinear regression models, the adjusted costs and length of stay for openappendectomy in patients with cerebrovascular diseases or diabetes mellitus were significantly higher than that for laparoscopic appendectomy. To reduce costs andlength of stay, patients with cerebrovascular diseases or diabetes mellitusshould be particularly recommended to receive laparoscopic approach rather thanan open approach for the treatment of acute appendicitis.