Impact of a clinical pathway and standardization of treatment for acute appendicitis.
OBJECTIVE
Acute appendicitis is one of the most common surgical diseases. Simple and precise guidelines for treating acute appendicitis are necessary for improving the treatment outcome of this disease. The purpose of this study was to determine the impact of a clinical pathway and standardization of treatment for acute appendicitis at our hospital.


METHODS
The clinical pathway and standardization of treatment for acute appendicitis were introduced to our hospital in January 2000. We compared the length of hospitalization, postoperative stay, hospital costs, and operation time during the years before and the years after their introduction.


RESULTS
There was no significant difference in the clinical characteristics of the 73 patients in the control group and the 112 patients in the pathway group. There were 6 (8.2%) and 24 (21.4%) cases of perforated appendicitis in the respective groups. The mean length of hospitalization ( P < 0.001), postoperative stay ( P < 0.001), and hospital costs ( P < 0.01) were significantly less in the patients in the pathway group who underwent surgery.


CONCLUSIONS
Our clinical pathway and standardization of treatment for acute appendicitis proved effective for treating patients with acute appendicitis and minimizing costs without compromising patient care.
Takegami
Kenji
K
Department of Surgery, Kikkoman General Hospital, 100 Miyazaki, Noda, Chiba 278-0005, Japan.
Kawaguchi
Yonei
Y
Nakayama
Hiroshi
H
Kubota
Yoshiro
Y
Nagawa
Hirokazu
H
D000208:Acute Disease; D000328:Adult; D001062:Appendectomy / Q000592:standards*; D001064:Appendicitis / Q000191:economics / Q000601:surgery*; D019091:Critical Pathways; D004630:Emergencies; D005260:Female; D017721:Hospital Costs; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome