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Comment & Response
May 15, 2019

Questioning the Higher Abscess Rate and Overall Cost of Care Associated With Nonoperative Management of Uncomplicated Acute Appendicitis—Reply

Author Affiliations
  • 1Stanford-Surgery Policy Improvement Research and Education (S-SPIRE) Center, Department of Surgery, Stanford University, Stanford, California
  • 2Division of Trauma, Emergency Surgery and Surgical Critical Care, Department of Surgery, Stanford University, Stanford, California
JAMA Surg. 2019;154(8):784-785. doi:10.1001/jamasurg.2019.1162

In Reply We thank Salminen and Grönroos for their interest in our study1 and for the opportunity to engage in continued dialogue over this important topic. The authors voice concern about 2 points in our study: (1) that the increased abscess rate seen in our retrospective cohort may be related to incorrectly included patients with complicated appendicitis and (2) that the higher overall cost of care seen for nonoperatively managed patients does not account for indirect societal costs.

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