Observational studyEuropean journal of trauma and emergency surgery : official publication of the European Trauma Society2023
Clinical practice selectively follows acute appendicitis guidelines.
Observational study in European journal of trauma and emergency surgery : official publication of the European Trauma Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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Who cites it
17 citing papers in PubMed, 19 citations in OpenAlex.
- Article
- The extended postoperative complication score: A dual-axis reporting plan for general surgery.The journal of trauma and acute care surgery · 2026Article
- Nutritional Status as a Risk Factor for Appendiceal Perforation in Pediatric Acute Appendicitis: Systematic Review.Children (Basel, Switzerland) · 2026Review
- A National survey of surgeons' perspectives on the treatment of adults with acute appendicitis.Langenbeck's archives of surgery · 2026Article
- Development of a risk prediction model for adhesive intestinal obstruction following laparoscopic surgery for acute appendicitis based on clinical characteristics and laboratory indicators.Frontiers in medicine · 2026Article
- Preoperative differentiation of acute appendicitis using NLR, SII, and maximum appendiceal diameter: a retrospective single-center diagnostic study.Frontiers in surgery · 2026Article
- Practice patterns and factors influencing surgical trainees' involvement in laparoscopic appendectomy in Northern Italy's largest educational network.Updates in surgery · 2025Article
- Small bowel obstruction outcomes according to compliance with the World Society of Emergency Surgery Bologna guidelines.The British journal of surgery · 2025Observational
- The Importance of the Neutrophil-Lymphocyte Ratio (NLR) and the Platelet-Lymphocyte Ratio (PLR) as Biomarkers for Differentiating Complicated and Uncomplicated Appendicitis.Diagnostics (Basel, Switzerland) · 2024Article
- Practice patterns and clinical outcomes in acute appendicitis differ in the elderly patient.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Observational
- Poor Compliance to Clinical Guidelines in the Diagnosis of Acute Appendicitis: Insights from a National Survey.Journal of clinical medicine · 2024Article
- European society for trauma and emergency surgery member-identified research priorities in emergency surgery: a roadmap for future clinical research opportunities.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2024Review
- The burden of the knowledge-to-action gap in acute appendicitis.Surgical endoscopy · 2023Article
- Validation of the modified Alvarado score on patients attending A&E units with suspected appendicitis.BMC emergency medicine · 2023Article
- Review
- Focus on identifying and closing knowledge gaps in acute appendicitis.European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2023Article
- Outcome of intra-operative Purulent Peritoneal Fluid Aspirate Culture Results during Appendicectomy in Patients' Management.Nigerian medical journal : journal of the Nigeria Medical AssociationArticle
Corrections and comments
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Authors and funding
8 authors at 5 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAcute appendicitis is a common surgical emergency, and the standard approach to diagnosis and management has been codified in several practice guidelines. Adherence to these guidelines provides insight into independent surgical practice patterns and institutional resource constraints as impediments to best practice. We explored data from the recent ESTES SnapAppy observational cohort study to determine guideline compliance in contemporary practice to identify opportunities to close evidence-to-practice gaps.
methodsWe undertook a preplanned analysis of the ESTES SnapAppy observational cohort study, identifying, at a patient level, congruence with, or deviation from WSES Jerusalem guidelines for the diagnosis and management of acute appendicitis and the Surviving Sepsis Campaign in our cohort. Compliance was then correlated with the incidence of postoperative complications.
resultsFour thousand six hundred and thirteen (4613) consecutive adult and adolescent patients with acute appendicitis were followed from date of admission (November 1, 2020, and May 28, 2021) for 90 days. Patient-level compliance with guideline elements allowed patients to be grouped into those with full compliance (all 5 elements: 13%), partial compliance (1-4 elements: 87%) or noncompliance (0 elements: 0.2%). We identified an excess postoperative complication rate in patients who received noncompliant and partially compliant care, compared with those who received fully guideline-compliant care (36% and 16%, versus 7.3%, p < 0.001).
conclusionsThe observed diagnostic and treatment practices of the participating institutions displayed variability in compliance with key recommendations from existing guidelines. In general, practice was congruent with recommendations for preoperative antibiotic surgical site infection prophylaxis administration, time to surgery, and operative approach. However, there remains opportunities for improvement in the choice of diagnostic imaging modality, postoperative antibiotic stewardship to timely discontinue prophylactic antibiotics, and the implementation of ambulatory treatment pathways for uncomplicated appendicitis in the healthy young adult.
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