Nonoperative management of acute appendicitis has high rates of later surgery and hospital visits, which surgeons should consider in patient selection.

• 33% of patients experienced a subsequent event (hospital visit or surgery) within 1 year, rising to 36% at 5 years.
• At 5 years, 16% had appendicitis-related hospital readmissions, 12% needed emergency surgery, and 21% underwent scheduled appendectomy.

Surgeons should weigh the risks of future interventions when opting for nonoperative management in appendicitis cases.

• For uncomplicated cases, 28% had interventions at 1 year and 32% by 5 years.