Management of Acute Appendicitis at District General Hospital

• Conditions: Covid19; Appendicitis Acute
• Interventions: Procedure: Appendicectomy

• Registration Number: NCT04707339
• Lead Sponsor: Princess Alexandra Hospital NHS Trust

Brief Summary

The Investigators aim to assess;

1. whether the changes in managing patients during COVID has reduced the negative appendicectomy rate?

2. compare the difference in outcomes of conservatively and surgically managed Acute Appendicitis?

3. Whether there uniformity in prescribing postoperative antibiotics with resultant outcomes?

4. Whether the incidence of complicated appendicitis has increased?

Detailed Description

As acute appendicitis is the most commonly managed emergency presentation for surgeons, the investigators aim to assess whether the changes in managing patients during COVID has reduced the negative appendicectomy rate, to compare the difference in outcomes of conservatively and surgically managed Acute Appendicitis? to assess whether there uniformity in prescribing postoperative antibiotics with resultant outcomes? to assess whether the incidence of complicated appendicitis has increased? This will be a single centre retrospective observational study. All the patients presenting in A\&E department with a diagnosis of acute appendicitis to be included. the only exclusion criteria are the age of participants for less than 5 years. The data will be analysed and calculated using SPSS version 23.

Study Timeline

• Study Start: 2020-01-30
• Primary Completion: 2020-10-31
• Status Verified: 2021-01
• Study First Submitted: 2021-01-11
• Study First Submitted QC: 2021-01-11
• Last Update Submitted: 2021-01-12
• Study First Posted: 2021-01-13
• Last Update Posted: 2021-01-14
• Study Completion: 2021-01-30

Recruitment & Eligibility

• Status: UNKNOWN
• Sex: All
• Target Recruitment: 200

Inclusion Criteria

• All participants reporting in accident and emergency with a diagnosis of acute appendicitis irrespective of age above 5 years, gender and morbidities (this group for conservative management)

Exclusion Criteria

• None

Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Arm && Interventions

Group	Intervention	Description
Acute Appendicitis pre-COVID management	Appendicectomy	Audit of Acute appendicitis management in 2017-18
Acute Appendicitis during COVID management	Appendicectomy	Audit of Acute appendicitis management in 2020

Primary Outcome Measures

Name	Time	Method
Negative Appendicectomy Rate	8 months	Negative appendicectomy rate will be calculated to define the benefits of increasing the preoperative scanning in the form of ultrasound, CT scan or both.
Outcomes of Conservative vs Operative Management	8 months	The outcomes of both conservatively and operatively managed patients will be assessed to define the best management approach.
Increased Open Appendicectomy Rate	8 months	The rate of laparoscopic to open and open appendicectomy rate will be calculated to understand if the surgical practice has been changed during COVID-19 pandemic?
Surgical site infection in patients on antibiotics	8 months	The rate of incidence of superficial and deep wound infection will be calculated to define the applicability of use of Antibiotics

Secondary Outcome Measures

Name	Time	Method
Length of Stay	8 months	The number of days of postoperative admission in hospital will be assessed while comparing the type of surgery and co-morbidities.

Trial Locations

Locations (1)

The Princess Alexandra Hospital NHS Trust; 🇬🇧 Harlow, Essex, United Kingdom