Management of Acute Appendicitis at District General Hospital

Study Overview
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Brief Summary
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The Investigators aim to assess; whether the changes in managing patients during COVID has reduced the negative appendicectomy rate? compare the difference in outcomes of conservatively and surgically managed Acute Appendicitis? Whether there uniformity in prescribing postoperative antibiotics with resultant outcomes? Whether the incidence of complicated appendicitis has increased?

Detailed Description
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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.

Official Title
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Management of Acute Appendicitis at District General Hospital

Conditions
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Appendicitis Acute, Covid19

Intervention / Treatment
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* Procedure: Appendicectomy


Participation Criteria
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Eligibility Criteria
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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
Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Acute Appendicitis pre-COVID management<br>Audit of Acute appendicitis management in 2017-18 | Procedure: Appendicectomy<br>* Laparoscopic or Open Appendicectomy<br>|
| Acute Appendicitis during COVID management<br>Audit of Acute appendicitis management in 2020 | Procedure: Appendicectomy<br>* Laparoscopic or Open Appendicectomy<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Negative Appendicectomy Rate | Negative appendicectomy rate will be calculated to define the benefits of increasing the preoperative scanning in the form of ultrasound, CT scan or both. | 8 months | 
| Outcomes of Conservative vs Operative Management | The outcomes of both conservatively and operatively managed patients will be assessed to define the best management approach. | 8 months | 
| Increased Open Appendicectomy Rate | 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? | 8 months | 
| Surgical site infection in patients on antibiotics | The rate of incidence of superficial and deep wound infection will be calculated to define the applicability of use of Antibiotics | 8 months | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Length of Stay | The number of days of postoperative admission in hospital will be assessed while comparing the type of surgery and co-morbidities. | 8 months | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Acute Appendicitis, COVID-19 pandemic, Management