Routine post-operative labs and healthcare system burden in acute appendicitis

Authors

Joshua A. Sznol, Department of Surgery, P.O. Box 208062, Yale School of Medicine, New Haven, CT 06520, USA. Electronic address: Joshua.sznol@yale.edu.
Robert Becher, Department of Surgery, P.O. Box 208062, Yale School of Medicine, New Haven, CT 06520, USA. Electronic address: Robert.becher@yale.edu.Follow
Adrian A. Maung, Department of Surgery, P.O. Box 208062, Yale School of Medicine, New Haven, CT 06520, USA. Electronic address: Adrian.maung@yale.edu.Follow
Bishwajit Bhattacharya, Department of Surgery, P.O. Box 208062, Yale School of Medicine, New Haven, CT 06520, USA. Electronic address: bishwajit.bhattacharya@yale.edu.Follow
Kimberly Davis, Department of Surgery, P.O. Box 208062, Yale School of Medicine, New Haven, CT 06520, USA. Electronic address: kimberly.davis@yale.edu.Follow
Kevin M. Schuster, Department of Surgery, P.O. Box 208062, Yale School of Medicine, New Haven, CT 06520, USA. Electronic address: kevin.schuster@yale.edu.Follow

Document Type

Article

Publication Title

American journal of surgery

Abstract

BACKGROUND: Data from the National Health Expenditure Accounts have shown a steady increase in healthcare cost paralleled by availability of laboratory tests. Resource utilization is a top priority for reducing health care costs. We hypothesized that routine post-operative laboratory utilization unnecessarily increases costs and healthcare system burden in acute appendicitis (AA) management. METHODS: A retrospective cohort of patients with uncomplicated AA 2016-2020 were identified. Clinical variables, demographics, lab usage, interventions, and costs were collected. RESULTS: A total of 3711 patients with uncomplicated AA were identified. Total costs of labs ($289,505, 99.56%) and repletions ($1287.63, 0.44%) were $290,792.63. Increased LOS was associated with lab utilization in multivariable modeling, increasing costs by $837,602 or 472.12 per patient. CONCLUSIONS: In our patient population, post-operative labs resulted in increased costs without discernible impact on clinical course. Routine post-operative laboratory testing should be re-evaluated in patients with minimal comorbidities as this likely increases cost without adding value.

First Page

571

Last Page

577

DOI

10.1016/j.amjsurg.2023.06.005

Publication Date

11-1-2023

Recommended Citation

Sznol, Joshua A.; Becher, Robert; Maung, Adrian A.; Bhattacharya, Bishwajit; Davis, Kimberly; and Schuster, Kevin M., "Routine post-operative labs and healthcare system burden in acute appendicitis" (2023). Surgery. 23.
https://scholar.bridgeporthospital.org/surgery/23

Identifier

37291012 (pubmed); 10.1016/j.amjsurg.2023.06.005 (doi); S0002-9610(23)00256-8 (pii)