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Prospective Observational Study on acute Appendicitis Worldwide (POSAW).
Massimo Sartelli1, Gian L Baiocchi2, Salomone Di Saverio3
1Department of Surgery, Macerata Hospital, Macerata, Italy.
World Journal of Emergency Surgery : WJES
|April 25, 2018
Summary
This study analyzed acute appendicitis (AA) diagnosis and treatment worldwide. Appendectomy remains the primary surgical treatment, with imaging and prognostic scores proving valuable for effective management and low mortality rates.
Area of Science:
- General Surgery
- Surgical Diagnostics
- Epidemiology
Background:
- Acute appendicitis (AA) is a common surgical condition requiring accurate diagnosis to minimize unnecessary surgeries.
- Management of complicated appendicitis presents clinical challenges.
- Global variations in clinical and diagnostic approaches to AA exist.
Purpose of the Study:
- To document the worldwide clinical and diagnostic work-up for acute appendicitis.
- To describe the contemporary management strategies for AA across global surgical departments.
Main Methods:
- Prospective, multicenter observational study.
- Involved 116 surgical departments in 44 countries over 6 months (April-September 2016).
- Included consecutive patients with a clinical diagnosis of AA.
Main Results:
- 4282 patients (45% female, 55% male, median age 29) were enrolled.
- Imaging included US (43.3%), CT (21.2%), or both (6.7%).
- 95.7% underwent surgery (42.2% open appendectomy, 51.7% laparoscopic appendectomy); 4.3% were managed conservatively. Major complications occurred in 4.6%, with a 0.28% mortality rate.
Conclusions:
- Imaging techniques and prognostic scores are clinically valuable for diagnosing AA.
- Appendectomy remains the most effective treatment for acute appendicitis.
- The overall mortality rate for AA is low.
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