Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. A new BJS study examined whether existing risk prediction models can reliably identify which UK patients with a low risk of appendicitis presenting to hospitals with acute right abdominal pain have appendicitis.
This largest worldwide multicentre study of suspected appendicitis in recent years included two-thirds of British hospitals providing emergency surgery (154 UK acute surgical units), making the findings generalisable across the UK. In addition, comparative data were collected from 120 hospitals across Italy, Portugal, the Republic of Ireland, and Spain. The study showed that women had a disproportionately higher risk of hospital admission without surgical intervention. Women who did undergo surgery had high rates of surgeries that removed a normal appendix.
Most risk prediction models were found to be unable to safely identify significant numbers of patients at low risk of appendicitis.
"Appendicectomy is the UK's most common emergency operation. Our study shows the world's highest published rate of normal appendicectomy--that is, surgery for suspected appendicitis but the diagnosis is wrong, and a normal appendix is removed," said corresponding author Aneel Bhangu, MBChB, PhD, FRCS, of the University of Birmingham. "The group most affected are young women and, every year, thousands of women aged 16 to 45 are suffering a sub-optimal experience in the UK."
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