Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.

Prospective Observational Study on acute Appendicitis Worldwide (POSAW)

Di Saverio S.;Ferrara F.;Ahmed A.;Bala M.;Das K.;Major P.;
2018

Abstract

Background: Acute appendicitis (AA) is the most common surgical disease, and appendectomy is the treatment of choice in the majority of cases. A correct diagnosis is key for decreasing the negative appendectomy rate. The management can become difficult in case of complicated appendicitis. The aim of this study is to describe the worldwide clinical and diagnostic work-up and management of AA in surgical departments. Methods: This prospective multicenter observational study was performed in 116 worldwide surgical departments from 44 countries over a 6-month period (April 1, 2016-September 30, 2016). All consecutive patients admitted to surgical departments with a clinical diagnosis of AA were included in the study. Results: A total of 4282 patients were enrolled in the POSAW study, 1928 (45%) women and 2354 (55%) men, with a median age of 29 years. Nine hundred and seven (21.2%) patients underwent an abdominal CT scan, 1856 (43.3%) patients an US, and 285 (6.7%) patients both CT scan and US. A total of 4097 (95.7%) patients underwent surgery; 1809 (42.2%) underwent open appendectomy and 2215 (51.7%) had laparoscopic appendectomy. One hundred eighty-five (4.3%) patients were managed conservatively. Major complications occurred in 199 patients (4.6%). The overall mortality rate was 0.28%. Conclusions: The results of the present study confirm the clinical value of imaging techniques and prognostic scores. Appendectomy remains the most effective treatment of acute appendicitis. Mortality rate is low.
Acute appendicitis; Antibiotics; Diagnosis; Management; Surgery
Sartelli, M.; Baiocchi, G. L.; Di Saverio, S.; Ferrara, F.; Labricciosa, F. M.; Ansaloni, L.; Coccolini, F.; Vijayan, D.; Abbas, A.; Abongwa, H. K.; Agboola, J.; Ahmed, A.; Akhmeteli, L.; Akkapulu, N.; Akkucuk, S.; Altintoprak, F.; Andreiev, A. L.; Anyfantakis, D.; Atanasov, B.; Bala, M.; Balalis, D.; Baraket, O.; Bellanova, G.; Beltran, M.; Melo, R. B.; Bini, R.; Bouliaris, K.; Brunelli, D.; Castillo, A.; Catani, M.; Che Jusoh, A.; Chichom-Mefire, A.; Cocorullo, G.; Coimbra, R.; Colak, E.; Costa, S.; Das, K.; Delibegovic, S.; Demetrashvili, Z.; Di Carlo, I.; Kiseleva, N.; El Zalabany, T.; Faro, M.; Ferreira, M.; Fraga, G. P.; Gachabayov, M.; Ghnnam, W. M.; Gimenez Maurel, T.; Gkiokas, G.; Gomes, C. A.; Griffiths, E.; Guner, A.; Gupta, S.; Hecker, A.; Hirano, E. S.; Hodonou, A.; Hutan, M.; Ioannidis, O.; Isik, A.; Ivakhov, G.; Jain, S.; Jokubauskas, M.; Karamarkovic, A.; Kauhanen, S.; Kaushik, R.; Kavalakat, A.; Kenig, J.; Khokha, V.; Khor, D.; Kim, D.; Kim, J. I.; Kong, V.; Lasithiotakis, K.; Leao, P.; Leon, M.; Litvin, A.; Lohsiriwat, V.; Lopez-Tomassetti Fernandez, E.; Lostoridis, E.; Maciel, J.; Major, P.; Dimova, A.; Manatakis, D.; Marinis, A.; Martinez-Perez, A.; Marwah, S.; Mcfarlane, M.; Mesina, C.; Pedziwiatr, M.; Michalopoulos, N.; Misiakos, E.; Mohamedahmed, A.; Moldovanu, R.; Montori, G.; Mysore Narayana, R.; Negoi, I.; Nikolopoulos, I.; Novelli, G.; Novikovs, V.; Olaoye, I.; Omari, A.; Ordonez, C. A.; Ouadii, M.; Ozkan, Z.; Pal, A.; Palini, G. M.; Partecke, L. I.; Pata, F.; Pedziwiatr, M.; Pereira Junior, G. A.; Pintar, T.; Pisarska, M.; Ploneda-Valencia, C. F.; Pouggouras, K.; Prabhu, V.; Ramakrishnapillai, P.; Regimbeau, J. -M.; Reitz, M.; Rios-Cruz, D.; Saar, S.; Sakakushev, B.; Seretis, C.; Sazhin, A.; Shelat, V.; Skrovina, M.; Smirnov, D.; Spyropoulos, C.; Strzalka, M.; Talving, P.; Teixeira Gonsaga, R. A.; Theobald, G.; Tomadze, G.; Torba, M.; Trana, C.; Ulrych, J.; Uzunoglu, M. Y.; Vasilescu, A.; Occhionorelli, S.; Venara, A.; Vereczkei, A.; Vettoretto, N.; Vlad, N.; Waledziak, M.; Yilmaz, T. U.; Yuan, K. -C.; Yunfeng, C.; Zilinskas, J.; Grelpois, G.; Catena, F.
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11383/2094568
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus 102
  • ???jsp.display-item.citation.isi??? 103
social impact