The Role of Imaging in the Diagnosis of Acute Appendicitis During the COVID-19 Pandemic

Study Overview
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Brief Summary
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This is a retrospective observational study in the form of a cohort study evaluating the use of pre-operative imaging for the diagnosis of acute appendicitis in a tertiary centre during the first and second waves of the COVID-19 pandemic in the United Kingdom. The study group includes all patients who underwent emergency appendicectomy for suspected acute appendicitis between March 2020 and February 2021, while the control group includes all patients who underwent emergency appendicectomy for suspected acute appendicitis between March 2019 and February 2020. The final histology will be used as primary outcome, as the study hypothesis is that increasing the use of pre-operative imaging will reduce the negative appendicectomy rate.

Official Title
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The Role of Imaging in the Diagnosis of Acute Appendicitis During the COVID-19 Pandemic: a Retrospective Cohort Study

Conditions
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Appendicitis

Intervention / Treatment
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* Diagnostic Test: Pre-operative imaging


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Patients of all ages who underwent emergency appendicectomy (either laparoscopic or open) for suspected acute appendicitis Patients of all ages who underwent partial ileo-caecectomy or right hemicolectomy for suspected acute appendicitis Exclusion Criteria: Patients who underwent elective interval appendicectomy for a previous appendiceal phlegmon Patients who underwent appendicectomy or right hemicolectomy for appendiceal tumours Patients who underwent diagnostic laparoscopy for suspected acute appendicitis, where the appendix was not removed
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Pandemic Group<br>All patients who underwent emergency appendicectomy for suspected acute appendicitis between March 2020 and February 2021 | Diagnostic Test: Pre-operative imaging<br>* Use of pre-operative imaging or the diagnosis of acute appendicitis<br>|
| Control Group<br>All patients who underwent emergency appendicectomy for suspected acute appendicitis between March 2019 and February 2020 | Diagnostic Test: Pre-operative imaging<br>* Use of pre-operative imaging or the diagnosis of acute appendicitis<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Negative Appendicectomy Rate (NAR) | Number of patients with final histology negative for acute appendicitis | Up to 3 weeks post-operatively (when final Histology is ready) | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Post-Operative Length of Stay | Post-operative length of hospital stay (from post-operative day 1) | Assessed on day 30 after the completion of the study | 
| Post-Operative Complications Rate | Number of patients who had post-operative complications | Within 30 post-operative days | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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appendicitis, COVID-19, negative appendicectomy rate, computer tomography, ultrasonography, pre-operative imaging