Antibiotic Management of Pediatric Appendicitis Linked to Lower Modeled Environmental Burden

A process-based life cycle assessment published in the Journal of the American College of Surgeons compared the environmental burden of laparoscopic appendectomy and nonoperative antibiotic treatment for pediatric uncomplicated appendicitis. The analysis modeled one completed episode of care, including initial treatment and downstream events over one year, using Ecoinvent databases within CarbonGraph EcoScan and the ReCiPe 2016 impact assessment method.

Appendectomy generated an estimated 15.20 kg of carbon dioxide equivalents (CO₂e) per episode, versus 5.98 kg for nonoperative management, including failures. Modeled environmentally mediated human health damage was 5.82 × 10⁻⁵ disability-adjusted life years (DALYs) with appendectomy and 2.14 × 10⁻⁵ DALYs with antibiotic management. In a population-level scenario, increasing nonoperative management uptake from 20% to 50% reduced climate change impact by 20.7% and human health damage by 21.7%, corresponding to approximately 66 metric tons of CO₂e annually.

These findings suggest that antibiotic management could reduce the environmental burden of care when clinically appropriate. However, the estimates concern modeled environmental impacts rather than directly measured patient outcomes. The supplied report does not specify a patient sample size or the population underlying the annual emissions estimate, limiting interpretation of its scale and generalizability.