title: Hospitalization costs of open vs. laparoscopic appendectomy: 5-year experience.
abstract: BACKGROUND
  There is an ongoing debate over certain aspects of laparoscopic appendectomy (LA) over open appendectomy (OA) in regard to hospitalization costs and associated complications.
  
  
  METHODS
  A database was used to obtain the charts for either LA or OA performed during a 5-year period. Variables analyzed were age, gender, hospitalization cost, length of stay and complications.
  
  
  RESULTS
  Of 1792 appendectomies performed, 633 (35.3%) were OA and 1159 (64.6%) were LA. Both groups were statistically similar with regard to gender (p = 0.075) but differed with respect to age, demonstrating an older patient population in the LA group (p <0.0001). Length of stay was significantly higher in the OA group (3.33 vs. 2.52) days, p <0.0001). The overall hospitalization cost of LA was 25% higher than the OA cost (p = 0.0005). The cost of an uncomplicated LA case was 1.7 times higher than in the OA group (p ≤ 0.0001). We found no statistically significant differences between the hospitalization cost of an OA and LA group when both procedures were associated with a complication (p = 0.5319). A higher complication rate was observed in the OA group, 60 cases (9.47%) as compared to the LA group, 46 cases (3.96%), p <0.0001. The increased rate of complications observed was related to cardiovascular, wound and infectious problems.
  
  
  CONCLUSIONS
  Noncomplicated LA was associated with a higher hospitalization cost. There was no difference with regard to complicated cases. The incidence of complications increased in the OA group.
authors.affiliation: Servicio Cirugía General, Centro Médico ABC, México, DF, Mexico. drcarloscardenas@hotmail.com
authors.forename: Carlos Michel
authors.initials: CM
authors.lastname: Cárdenas-Salomon
authors.forename: Jorge
authors.initials: J
authors.lastname: Cervantes-Castro
authors.forename: Enrique Ricardo
authors.initials: ER
authors.lastname: Jean-Silver
authors.forename: Sergio Alejandro
authors.initials: SA
authors.lastname: Toledo-Valdovinos
authors.forename: Adrián
authors.initials: A
authors.lastname: Murillo-Zolezzi
authors.forename: José Antonio
authors.initials: JA
authors.lastname: Posada-Torres
mesh_terms: D000328:Adult; D000367:Age Factors; D001062:Appendectomy / Q000191:economics* / Q000379:methods; D001064:Appendicitis / Q000150:complications / Q000191:economics / Q000601:surgery; D001424:Bacterial Infections / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D017721:Hospital Costs / Q000706:statistics & numerical data*; D006760:Hospitalization / Q000191:economics*; D006801:Humans; D010535:Laparoscopy / Q000191:economics* / Q000379:methods; D007813:Laparotomy / Q000191:economics* / Q000379:methods; D007902:Length of Stay / Q000191:economics / Q000706:statistics & numerical data; D008171:Lung Diseases / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008800:Mexico / Q000453:epidemiology; D011183:Postoperative Complications / Q000191:economics / Q000453:epidemiology; D012189:Retrospective Studies; D012737:Sex Factors; D014570:Urologic Diseases / Q000191:economics / Q000453:epidemiology / Q000209:etiology; D055815:Young Adult