{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:51:35Z","timestamp":1787241095182,"version":"build-2736575974"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T00:00:00Z","timestamp":1574726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T00:00:00Z","timestamp":1574726400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T00:00:00Z","timestamp":1574726400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2020,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Acute appendicitis is a common surgical emergency that is typically managed with laparoscopic appendicectomy in UK centres. A number of variables influence the cost of managing this condition. Our aim was to identify the major influencing factors in our centre by performing a cumulative cost analysis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analysed the costs associated with 99 cases of acute appendicitis managed with laparoscopic appendicectomy at Ninewells Hospital, Dundee, from January 2014 to February 2016. Costs were categorised according to blood tests, imaging, medications, operative costs and length of stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Our cohort included 66\u00a0males, 33 females and 28 paediatric cases. The total cost was \u00a3220030.52 with a mean of \u00a32222.53 per patient. The factor with the greatest influence on overall cost was operative time (53.2%) followed by length of stay (39.2%). There was no cost difference between adults and children (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.24) or males and females (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.38). Mean cost in adults \u226550 years was greater than those &lt;50 years (\u00a32899.32 vs \u00a32152.97,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.008) and greater in those who underwent imaging as opposed to no imaging (\u00a32789.53 vs \u00a32010.65,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0001). For appendiceal stump technique, polymer clips were cheaper (\u00a31844.70) than ligatures (\u00a32380.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Operative time (53.2%) and length of stay (39.2%) had the greatest impact on the cost in our cohort. Older patients have a greater overall cost, and this is associated with increased utilisation of imaging. Further studies assessing the safety and feasibility of methods to reduce operative time and to investigate the safety of reducing length of stay are required.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00268-019-05306-2","type":"journal-article","created":{"date-parts":[[2019,11,26]],"date-time":"2019-11-26T14:02:48Z","timestamp":1574776968000},"page":"749-754","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["What is the Operative Cost of Managing Acute Appendicitis in the NHS: The Impact of Stump Technique and Perioperative Imaging"],"prefix":"10.1002","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5251-7795","authenticated-orcid":false,"given":"K. D.","family":"Clement","sequence":"first","affiliation":[{"name":"Department of General Surgery Ninewells Hospital James Arnott Drive DD2 1SY Dundee UK"},{"name":"Department of Urology Queen Elizabeth University Hospital 1345 Govan Road G51 4TF Glasgow UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Emslie","sequence":"additional","affiliation":[{"name":"Department of General Surgery Ninewells Hospital James Arnott Drive DD2 1SY Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.","family":"Maniam","sequence":"additional","affiliation":[{"name":"Ninewells Hospital and Medical School James Arnott Drive DD2 1SY Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. S. J.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of General Surgery Ninewells Hospital James Arnott Drive DD2 1SY Dundee UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2019,11,26]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115734"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017\u2010016\u20100090\u20105"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9201"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/000313480607200509"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1703"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1308\/003588409X432383"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2013.05.001"},{"key":"e_1_2_8_9_1","unstructured":"NHS reference costs 2014 to 2015: Department of Health and Social Care. 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