Complication analysis in acute appendicitis, results from an international multicenter study

Area of Science:

• Gastroenterology
• Surgical Oncology
• Clinical Epidemiology

Background:

• Acute appendicitis (AA) diagnosis is challenging, and appendectomy carries surgical risks.
• Accurate diagnosis is crucial to minimize unnecessary surgeries and associated complications.

Purpose of the Study:

• To analyze the rate of postoperative complications following appendectomies.
• To identify factors associated with increased risk of complications.

Main Methods:

• Multicenter, prospective, observational study across three European hospitals.
• Data collected on 3070 patients undergoing appendectomy, including demographics, imaging, and surgical approach.
• Complication rates assessed using the Clavien-Dindo classification.

Main Results:

• 41.7% of patients experienced complications, with 5.2% having severe (Clavien-Dindo grades III-IV) complications.
• Older age, higher Charlson comorbidity index, specific histopathology, and Alvarado score >7 were linked to higher complication risk.
• 15% of patients with normal appendix resection had major complications (Clavien-Dindo grades IIIb+).

Conclusions:

• Appendectomy is associated with significant postoperative complications, influenced by patient factors and diagnostic scores.
• Clinical scores and radiological findings should be integrated for improved diagnostic and therapeutic strategies.
• Refining diagnostic and treatment pathways is essential to improve appendectomy outcomes.