A "textbook outcome" patient is defined as one whose surgical course is uneventful, with no complications, readmissions, or mortality. There is a lack of published research regarding textbook outcomes with an acute appendicitis that are treated with an appendectomy.
The objective of this study is to analyze the attainment of textbook outcomes (TO) in patients undergoing urgent appendicectomy (UA) for acute appendicitis and to identify the factors associated with achieving TO.
Study Type
OBSERVATIONAL
Enrollment
500
Textbook Outcomes
Classical assessments, focused solely on mortality and morbidity, are increasingly considered insufficient. A more comprehensive approach, using composite measures, offers a more accurate evaluation, providing a multidimensional view and patient-centred healthcare appraisal. The textbook outcome (TO) is the most used objective composite measure to compare surgical quality across centres
Time frame: 2022-2024
Appendectomy in less than 24h
From diagnostic of Acute Appendicitus to Surgical Treatment should be less than 24h
Time frame: 2022-2024
Hospital Stay less than 5 days
Optimal hospital stay should be less than 5 days
Time frame: 2022-2024
Intraoperative incidences
Intraoperative bleeding, perforation of the appendix, iatrogenic injury to other structures
Time frame: 2022-2024
Short antibiotics treatment
Less than 72h of antibiotic treatment
Time frame: 2022-2024
Patient comorbidities
Charlson Comorbidity Index
Time frame: 2022-2024
Surgical Risk
ASA Scoring System
Time frame: 2022-2024
Intraoperative appendicitis gradding
AAST classification AAST I: Acutely inflamed appendix, intact. AAST II:Gangrenous appendix, intact AAST III:Above, with evidence of local contamination AAST IV:Above, with abscess or phlegmon in region of appendix AAST V:Above, with addition of generalized purulent contamination away from appendix WSES Classification: Grade- 0 (normal looking) Grade-1 (inflamed) Grade- 2A and 2B (necrosis) Grade- 3A - 3B - 3C (perforated - inflammatory tumor) Grade- 4 (perforate - diffuse peritonitis)
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Time frame: 2022-2024
Postperative complications
Clavien Dindo and CCI (https://www.cci-calculator.com/) Grade I: Any deviation from the normal postoperative course without the need for pharmacological treatment or surgical, endoscopic, and radiological interventions. Grade II:Requiring pharmacological treatment with drugs other than such allowed for Grade I Grade III:Requiring surgical, endoscopic or radiological intervention. Grade IV:Life-threatening complication (including CNS complications)\* requiring IC/ICU-management with single or multiorgan disfunction. Grade V: Death of a patient
Time frame: 2022-2024
Readmision index
Percentage of readmission
Time frame: 2022-2024