Evidence map›Paper›PMID 29686725›Full record

Observational studyWorld journal of emergency surgery : WJES2018

Prospective Observational Study on acute Appendicitis Worldwide (POSAW).

Massimo Sartelli, Gian L Baiocchi, Salomone Di Saverio, Francesco Ferrara, Francesco M Labricciosa, Luca Ansaloni, Federico Coccolini, Deepak Vijayan, Ashraf Abbas, Hariscine K Abongwa and 139 more

Open access · goldAbstract readMulticenter StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in World journal of emergency surgery : WJES, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 117 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
117citing papers in PubMed, 9 pooled it
33.8field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

117 citing papers in PubMed, 9 syntheses or guidelines pooled it, 270 citations in OpenAlex.

  1. Appendectomy versus antibiotic treatment for acute appendicitis.The Cochrane database of systematic reviews · 2024
    Pooled it
  2. Pooled it
  3. Aspiration versus peritoneal lavage in appendicitis: a meta-analysis.World journal of emergency surgery : WJES · 2021
    Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Acute Appendicitis in Childhood and Adulthood.Deutsches Arzteblatt international · 2020
    Pooled it
  9. Pooled it
  10. Trial
  11. Article
  12. Efficacy of the LigaSure system vs UltraCision harmonic scalpel in laparoscopic appendectomy for the management of acute appendicitis.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2026
    Article
  13. Article
  14. Article
  15. Association of Sex, Age, and Inflammatory Cell Counts with Complicated Acute Appendicitis.Pathophysiology : the official journal of the International Society for Pathophysiology · 2026
    Article
  16. Review
  17. Review
  18. Saline solution vs. stabilized isotonic sodium hypochlorite lavage in complicated appendicitis: a comparative study.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2026
    Article
  19. Article
  20. Article

57 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

149 authors at 20 institutions in 46 countries.

Massimo SartelliDepartment of Surgery, Macerata Hospital, Macerata, Italy.
Gian L Baiocchi2Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy.
Salomone Di Saverio3Emergency Surgery, Maggiore Hospital, Bologna, Italy.
Francesco Ferrara4General Surgery and Polytrauma, San Carlo Borromeo Hospital, Milan, Italy.
Francesco M LabricciosaDepartment of Biomedical Sciences and Public Health, Unit of Hygiene, Preventive Medicine and Public Health, UNIVPM, Ancona, Italy.
Luca Ansaloni6Department of Surgery, Bufalini Hospital, Cesena, Italy.
Federico Coccolini6Department of Surgery, Bufalini Hospital, Cesena, Italy.
Deepak Vijayan7General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Ashraf Abbas8Emergency Surgery, Mansoura University Hospital, Mansoura, Egypt.
Hariscine K Abongwa9Emergency Surgery Unit, Maggiore University Hospital, Parma, Italy.
John AgboolaSurgery, Kwara State General Hospital, Ilorin, Kwara Nigeria.
Adamu Ahmed11Surgery, Ahmadu Bello University Teaching Hospital Zaria, Zaria, Nigeria.
Lali AkhmeteliSurgery, First University Clinic, Tbilisi, Georgia.
Nezih Akkapulu13General Surgery, Baskent Universitesi Adana Eğitim ve Uygulama Hastanesi, Adana, Turkey.
Seckin Akkucuk14General Surgery, Training and Research Hospital of Mustafa Kemal University, Hatay, Turkey.
Fatih Altintoprak15General Surgery, Sakarya University School of Medicine, Sakarya, Turkey.
Aurelia L Andreiev7General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Dimitrios AnyfantakisPrimary Care, Primary Health Care Centre of Kissamos, Chania, Greece.
Boiko Atanasov17Department of General Surgery, Medical University of Plovdiv, UMHAT Eurohospital, Plovdiv, Bulgaria.
Miklosh Bala18General Surgery, Hadassah Medical Center, Jerusalem, Israel.
Dimitrios BalalisSurgical Department, Agios Savvas Anticaner Hospital, Athens, Greece.
Oussama BaraketGeneral Surgery, Hospital Habib Bouguefa de Bizerte, Bizerte, Tunisia.
Giovanni BellanovaGeneral Surgery, S.S. Annunziata Hospital, Taranto, Italy.
Marcelo BeltranSurgery, Hospital San Juan de Dios de La Serena, La Serena, Chile.
Renato Bessa Melo23General Surgery, Centro Hospitalar São João, Porto, Portugal.
Roberto Bini24General and Emergency Surgery, San Giovanni Bosco Hospital, Turin, Italy.
Konstantinos BouliarisSurgical Department, General Hospital of Larissa, Larissa, Greece.
Daniele BrunelliChirurgia, Città di Castello Hospital, Città di Castello, Italy.
Adrian Castillo27Department of Surgery, Harbor-UCLA Medical Center, Torrance, USA.
Marco Catani28DEA, La Sapienza Università di Roma, Policlinico Umberto I, Rome, Italy.
Asri Che JusohGeneral Surgery, Kuala Krai Hospital, Kuala Krai, Kelantan Malaysia.
Alain Chichom-MefireSurgery and Obstetrics/Gynaecology, Regional Hospital, Limbe, Cameroon.
Gianfranco Cocorullo31Emergency Surgery, Azienda Ospedaliera Universitaria Policlinico Paolo Giaccone, Palermo, Italy.
Raul Coimbra32Trauma/Acute Care Surgery, University of California San Diego, San Diego, USA.
Elif ColakGeneral Surgery, Samsun Training and Research Hospital, Samsun, Turkey.
Silvia Costa34Surgery, CHVNG/E, EPE, Vila Nova de Gaia, Portugal.
Koray Das35General Surgery, Numune Training and Research Hospital, Adana, Turkey.
Samir Delibegovic36Colorectal Surgery, Clinic for Surgery, University Clinical Center Tuzla, Tuzla, Bosnia and Herzegovina.
Zaza DemetrashviliSurgery, Kipshidze Central University Hospital, Tbilisi, Georgia.
Isidoro Di Carlo38Surgery, Hamad General Hospital, Doha, Qatar.
Nadezda Kiseleva39General and Emergency Surgery, Riga East University Hospital "Gailezers", Riga, Latvia.
Tamer El ZalabanyGeneral Surgery, Bahrain Defence Force Hospital, Manama, Bahrain.
Mario Faro41Department of General Surgery, Trauma and Emergency Surgery Division, ABC Medical School, Santo Andreì, SP Brazil.
Margarida Ferreira42General Surgery, Hospital Garcia de Orta, Lisbon, Portugal.
Gustavo P Fraga43Division of Trauma Surgery, Hospital de Clinicas, University of Campinas (Unicamp), Campinas, Brazil.
Mahir GachabayovDepartment of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia.
Wagih M Ghnnam45General Surgery Department, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt.
Teresa Giménez Maurel46Cirugía General y del Aparato Digestivo, Hospital Universitario Miguel Servet, Zaragoza, Spain.
Georgios Gkiokas47Second Department of Surgery, Aretaieion University Hospital, National and Kapodistrian University of Athens, Athens, Greece.
Carlos A GomesSurgery, Therezinha de Jesus University Hospital, Juiz de Fora, Brazil.
Ewen Griffiths49Upper GI/General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Ali Guner50Department of General Surgery, Karadeniz Technical University, Farabi Hospital, Trabzon, Turkey.
Sanjay Gupta51Surgery, Government Medical College and Hospital, Chandigarh, India.
Andreas Hecker52Department of General and Thoracic Surgery, University Hospital, Giessen, Germany.
Elcio S Hirano43Division of Trauma Surgery, Hospital de Clinicas, University of Campinas (Unicamp), Campinas, Brazil.
Adrien HodonouChirurgie, Chud-Borgou/Alibori, Parakou, Benin.
Martin HutanSurgical Department, Landesklinikum Hainburg, Hainburg An Der Donau, Austria.
Orestis Ioannidis554th Surgical Department, Aristotle University of Thessaloniki, Thessaloniki, Greece.
Arda Isik57General Surgery, Erzincan University Mengucek Gazi Training and Research Hospital, Erzincan, Turkey.
Georgy IvakhovGeneral Surgery, City Hospital #1, Moscow, Russia.
Sumita Jain59Surgery, S M S Medical college, Jaipur, India.
Mantas Jokubauskas60Department of Surgery, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.
Aleksandar Karamarkovic61Clinic for Emergency Surgery, Faculty of Medicine University of Belgrade, Belgrade, Serbia.
Saila Kauhanen62Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland.
Robin Kaushik51Surgery, Government Medical College and Hospital, Chandigarh, India.
Alfie Kavalakat63General Surgery, Jubilee Mission Medical College & Research Institute, Thrissur, India.
Jakub Kenig643rd Department of General Surgery, Jagiellonian University Medical College, Krakow, Poland.
Vladimir KhokhaEmergency surgery, City Hospital, Mozyr, Belarus.
Desmond Khor66Acute Care Surgery, LAC+USC Medical Center, California, USA.
Dennis Kim27Department of Surgery, Harbor-UCLA Medical Center, Torrance, USA.
Jae I Kim67Department of Surgery, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea.
Victor Kong68Department of Surgery, Edendale Hospital, Pietermaritzburg, South Africa.
Konstantinos LasithiotakisGeneral Surgery, Scarborough, York Teaching Hospital, Scarborough, UK.
Pedro LeãoGeneral Surgery, Colorectal Unit, Hospital de Braga, Braga, Portugal.
Miguel Leon71General and Digestive Surgery, Hospital Fundación Jimenez Diaz, Madrid, Spain.
Andrey LitvinSurgical Disciplines, Regional Clinical Hospital, Kaliningrad, Russia.
Varut Lohsiriwat73Faculty of Medicine, Department of Surgery, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Eudaldo López-Tomassetti FernandezDepartment of Gastrointestinal Surgery, Insular University Hospital of Gran Canaria, Las Palmas, Spain.
Eftychios Lostoridis1st Department of Surgery, Kavala General Hospital, Kavala, Greece.
James Maciel27Department of Surgery, Harbor-UCLA Medical Center, Torrance, USA.
Piotr Major762nd Department of Surgery, Jagiellonian University Medical College, Krakow, Poland.
Ana Dimova77Clinic of surgery, Department of Gastrointestinal Surgery, University Hospital Centre Zagreb, Zagreb, Croatia.
Dimitrios Manatakis78Surgical Department, Konstantopouleio General Hospital, Athens, Greece.
Athanasio Marinis79First Department of Surgery, Tzaneio, Piraeus, Greece.
Aleix Martinez-Perez80Department of General and Digestive Surgery, Hospital Universitario Doctor Peset, Valencia, Spain.
Sanjay Marwah81Department of General Surgery, Post-Graduate Institute of Medical Sciences, Rohtak, India.
Michael McFarlane82Department of Surgery, Radiology, Anaesthetics and Intensive Care, University of the West Indies, Kingston, Jamaica.
Cristian MesinaDepartment of Surgery Second Surgical Clinic, Emergency Hospital of Craiova, Craiova, Romania.
Michał Pędziwiatr85Department of General Surgery and Emergency Medicine, University Hospital, Kraków, Poland.
Nickos Michalopoulos863rd Department of Surgery, Ahepa University Hospital, Thessaloniki, Greece.
Evangelos Misiakos873rd Department of Surgery, Attikon University Hospital, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
Ali MohamedahmedGeneral Surgery, Khartoum Teaching Hospital, Khartoum, Sudan.
Radu MoldovanuDepartment of Visceral, Digestive and Oncologic Surgery, Clinique Sainte Marie, Cambrai, France.
Giulia Montori6Department of Surgery, Bufalini Hospital, Cesena, Italy.
Raghuveer Mysore NarayanaGeneral Surgery, K R Hospital, Mysore, India.
Ionut NegoiGeneral Surgery, Emergency Hospital of Bucharest, Bucharest, Romania.
Ioannis Nikolopoulos92General Surgery, Lewisham and Greenwich NHS Trust, London, UK.
Giuseppe Novelli93General, Emergency Surgery, Infermi Hospital, Rimini, Italy.
Viktors Novikovs39General and Emergency Surgery, Riga East University Hospital "Gailezers", Riga, Latvia.
Iyiade Olaoye94Surgery, University of Ilorin Teaching Hospital, Ilorin, Nigeria.
Abdelkarim Omari95General Surgery, King Abdullah University Hospital, Irbid, Jordan.
Carlos A Ordoñez96Division of Trauma and Acute Care Surgery, Department of Surgery, Fundación Valle del Lili and Universidad del Valle, Cali, Colombia.
Mouaqit OuadiiSurgery Departement, Medical School of Fezm, Sidi Mohamed Benabdellah University, Fez, Morocco.
Zeynep OzkanGeneral Surgery, Elazig Training and Research Hospital, Elazig, Turkey.
Ajay Pal99General Surgery, King George's Medical University, Lucknow, India.
Gian M Palini93General, Emergency Surgery, Infermi Hospital, Rimini, Italy.
Lars I ParteckeSurgery, University Hospital, Greifswald, Germany.
Francesco PataDepartment of General Surgery, Sant'Antonio Abate Hospital, Gallarate, Italy.
Michał Pędziwiatr102Department of Emergency Surgery and Trauma Centre, University Hospital, Kraków, Poland.
Gerson A Pereira Júnior103Surgery and Anatomy, Clinics Hospital, Ribeirão Preto, Brazil.
Tadeja Pintar104Abdominal surgery, UMC Ljubljana, Ljubljana, Slovenia.
Magdalena Pisarska105Department of Endoscopic, Metabolic and Soft Tissue Tumors Surgery, The University Hospital in Krakow, Kraków, Poland.
Cesar F Ploneda-Valencia106General Surgery, Hospital Civil de Guadalajara "Dr. Juan I. Menchaca", Guadalajara, Mexico.
Konstantinos Pouggouras1st Department of Surgery, Kavala General Hospital, Kavala, Greece.
Vinod Prabhu107Surgery, Bharati Vidyapeeth Deemed University Medical College & Hospital, Sangli, Maharashtra India.
Padmakumar RamakrishnapillaiLaparoscopic and Metabolic Surgery, KIMS Hospital, Cochin, India.
Jean-Marc Regimbeau109Digestive Surgery, CHU Amiens-Picardie, Amiens, France.
Marianne ReitzGeneral Surgery, Hospital Municipal Dr. Jose de Carvalho Florence, Sao Jose Dos Campos, Brazil.
Daniel Rios-CruzGeneral Surgery, Hospital General Regional # 1 I.M.S.S, Cuernavaca, Mexico.
Sten SaarAcute Care Surgery, North Estonia Medical Center, Tallinn, Estonia.
Boris SakakushevGeneral Surgery, University Hospital St George, Plovdiv, Bulgaria.
Charalampos Seretis114General Surgery, Russells Hall Hospital, Birmingham, UK.
Alexander SazhinGeneral Surgery, City Hospital #1, Moscow, Russia.
Vishal Shelat115General Surgery, Tan Tock Seng Hospital, Singapore, Singapore.
Matej SkrovinaSurgery, Hospital & Oncological Centre Novy Jicin, Novy Jicin, Czech Republic.
Dmitry SmirnovGeneral Surgery, Clinical Hospital at Chelyabinsk Station OJSC "Russian Railways", Chelyabinsk, Russian Federation.
Charalampos Spyropoulos1183rd Department of Surgery, IASO General Hospital, Athens, Greece.
Marcin Strzałka119General Surgery and Polytrauma, University Hospital, Medical College, Jagiellonian University, Kraków, Poland.
Peep TalvingAcute Care Surgery, North Estonia Medical Center, Tallinn, Estonia.
Ricardo A Teixeira GonsagaCirurgia do Trauma, Hospital Escola Padre Albino, Catanduva, Brazil.
George Theobald7General Surgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK.
Gia Tomadze121Surgery Department #2, Tbilisi State Medical University, Tbilisi, Georgia.
Myftar TorbaGeneral Surgery, Trauma University Hospital, Tirana, Albania.
Cristian TranàDepartment of Surgery, Macerata Hospital, Macerata, Italy.
Jan Ulrych1231st Department of Surgery-Department of Abdominal Thoracic Surgery and Traumatology, General University Hospital, Prague, Czech Republic.
Mustafa Y Uzunoğlu14General Surgery, Training and Research Hospital of Mustafa Kemal University, Hatay, Turkey.
Alin VasilescuFirst Surgical Clinic, St. Spiridon University Hospital, Iasi, Romania.
Savino OcchionorelliEmergency Surgery, S. Anna Teaching Hospital, Ferrara, Italy.
Aurélien Venara126Digestive and Endocrinal Surgery, University Hospital, Angers, France.
Andras Vereczkei127Department of Surgery, Medical School University of Pécs, Pécs, Hungary.
Nereo VettorettoSurgery, ASTS Spedali Civili Brescia, Montichiari, Italy.
Nutu VladFirst Surgical Clinic, St. Spiridon University Hospital, Iasi, Romania.
Maciej Walędziak129Department of General, Oncological, Metabolic and Thoracic Surgery, Military Institute of Medicine in Warsaw, Warsaw, Poland.
Tonguç U Yilmaz130Department of General Surgery, Kocaeli University, Kocaeli, Turkey.
Kuo-Ching YuanTrauma and Emergency Surgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan.
Cui Yunfeng132Department of Surgery, Tianjin Nankai Hospital, Tianjin, China.
Justas Zilinskas60Department of Surgery, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania.
Gérard Grelpois109Digestive Surgery, CHU Amiens-Picardie, Amiens, France.
Fausto Catena8Emergency Surgery, Mansoura University Hospital, Mansoura, Egypt.
University Hospitals Birmingham NHS Foundation Trust · GBJagiellonian University · PLOspedale “M. Bufalini” di Cesena · ITUCLA Medical Center · USCentre Hospitalier Universitaire Amiens-Picardie · FRGovernment Medical College and Hospital · INHospital of Lithuanian University of Health Sciences Kaunas Clinics · LTMansoura University Hospital · EGMoscow City Hospital No 29 · RUMustafa Kemal University · TRNational and Kapodistrian University of Athens · GRNorth Estonia Medical Centre · EEOspedale di MacerataOspedale Infermi di Rimini · ITRiga East University Hospital · LVSpitalul Clinic Judeţean de Urgenţe "Sf. Spiridon" Iaşi · ROTechnological Educational Institute of Eastern Macedonia and Thrace · GRUniversidade Estadual de Campinas (UNICAMP) · BR9th City Clinical Hospital · BYAgia Olga Hospital · GR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

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.

Indexed as

Acute DiseaseAdultAppendectomyAppendicitisChi-Square DistributionFemaleHospitalizationHumansLaparoscopyLength of StayLogistic ModelsMaleProspective StudiesTomography, X-Ray ComputedTreatment OutcomeAcute appendicitisAntibioticsDiagnosisManagementSurgery

Identifiers

PMID29686725
PMCPMC5902943
OpenAlexW2803280558

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.