Textbook Outcomes in Urgent Appendectomy

Not yet recruiting

• Conditions: Valid MeSH Conditions

• Registration Number: NCT06765044
• Lead Sponsor: Hospital del Mar

Brief Summary

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.

Detailed Description

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 Timeline

• Study First Submitted: 2024-12-17
• Status Verified: 2025-01
• Study First Submitted QC: 2025-01-02
• Last Update Submitted: 2025-01-02
• Study First Posted: 2025-01-09
• Last Update Posted: 2025-01-09
• Study Start: 2025-01-15
• Primary Completion: 2025-01-15
• Study Completion: 2025-02-15

Recruitment & Eligibility

• Status: NOT_YET_RECRUITING
• Sex: All
• Target Recruitment: 500

Inclusion Criteria

• Acute Appendicits in older than 18 years old
• Acute Appendicitis that needs appendectomy

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Exclusion Criteria

• Age under 18 years old
• Other diagnostic than an Acute Appendicitis

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Study & Design

• Study Type: OBSERVATIONAL
• Study Design: Not specified

Primary Outcome Measures

Name	Time	Method
Textbook Outcomes	2022-2024	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

Secondary Outcome Measures

Name	Time	Method
Postperative complications	2022-2024	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
Readmision index	2022-2024	Percentage of readmission
Appendectomy in less than 24h	2022-2024	From diagnostic of Acute Appendicitus to Surgical Treatment should be less than 24h
Hospital Stay less than 5 days	2022-2024	Optimal hospital stay should be less than 5 days
Intraoperative incidences	2022-2024	Intraoperative bleeding, perforation of the appendix, iatrogenic injury to other structures
Short antibiotics treatment	2022-2024	Less than 72h of antibiotic treatment
Intraoperative appendicitis gradding	2022-2024	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)
Patient comorbidities	2022-2024	Charlson Comorbidity Index
Surgical Risk	2022-2024	ASA Scoring System