Re-Assessment in Patients with Suspected Acute Appendicitis

Area of Science:

• Surgical outcomes
• Appendicitis diagnosis
• Emergency medicine

Background:

• The impact of delayed appendicitis diagnosis on surgical outcomes remains unclear.
• Comparing initial versus re-assessment diagnosis is crucial for optimizing patient care.

Purpose of the Study:

• To compare post-operative outcomes in patients diagnosed with appendicitis at initial presentation versus re-assessment.
• To evaluate the rates of complicated appendicitis and post-operative complications between the two diagnostic groups.

Main Methods:

• Utilized data from the Dutch SNAPSHOT appendicitis collaborative.
• Included patients who underwent appendectomy for appendicitis.
• Compared outcomes based on diagnosis at initial presentation versus re-assessment.

Main Results:

• Of 1,832 patients, 13.4% were diagnosed at re-assessment.
• Re-assessed patients had comparable overall post-operative complication rates (15.1% vs. 12.7%) and complicated appendicitis proportions (27.9% vs. 33.5%).
• Patients with complicated appendicitis diagnosed at re-assessment had significantly more post-operative complications (38.2% vs. 22.9%; p=0.006).

Conclusions:

• Delayed appendicitis diagnosis at re-assessment did not significantly increase overall complicated appendicitis or post-operative complications.
• However, a higher rate of post-operative complications occurred in re-assessed patients with complicated appendicitis.
• This highlights the importance of timely diagnosis, especially in severe appendicitis cases.